Treatment of Lyme Disease with Lyme Carditis in Haemodynamically Stable Patients Aged 9 and Over

When Lyme disease is complicated by Lyme carditis and the patient remains haemodynamically stable, a specific antibiotic protocol applies. This page outlines the clinical scenario and treatment approach for patients aged 9 years and over.

Clinical Scenario

The patient has confirmed Lyme disease with concurrent Lyme carditis — cardiac involvement associated with Borrelia infection. Haemodynamic stability at presentation is a key determinant of the treatment pathway. This protocol is indicated for patients aged 9 years and over, with weight-based dosing considerations applying within the paediatric range.

Treatment Approach (Partial Overview)

Antibiotic therapy is the recommended approach for this presentation — with a primary agent and an alternative option available, both structured for a defined course with weight-adjusted dosing for paediatric patients. The complete agent selection, criteria, and dosing algorithm are in the full protocol.

References

DOI: 10.1093/cid/ciaa1215

  • Lyme disease with Lyme carditis
  • Lyme disease with Lyme carditis and haemodynamically stable
  • For adults and young people (aged 12 and over) diagnosed with Lyme disease, offer antibiotic treatment according to their symptoms as described in table 1.
  • Oral doxycycline: 100 mg twice per day or 200 mg once per day for 21 days
  • Intravenous ceftriaxone: 2 g once per day for 21 days
  • Oral doxycycline for children under 45 kg: 5 mg/kg in 2 divided doses on day 1 followed by 2.5 mg/kg daily in 1 or 2 divided doses for a total of 21 days
  • Intravenous ceftriaxone for children under 50 kg: 80 mg/kg (up to 2 g) once per day for 21 days
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