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Oral Doxycycline Was a Safe and Feasible Treatment in Young Children With Neuroborreliosis

Joakim Bloch1,2, Lisbeth Schmidt2,3, Nadja Vissing1

  • 1Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.

Acta Paediatrica (Oslo, Norway : 1992)
|April 5, 2025
PubMed

Insights

Oral doxycycline is a feasible and effective treatment for neuroborreliosis in children under nine years old. This study found low rates of adverse effects and no symptom progression or relapse in young patients treated with doxycycline.

Area of Science:

  • Pediatric infectious diseases
  • Neurology
  • Pharmacology

Background:

  • Limited evidence exists regarding oral doxycycline use in young children.
  • Neuroborreliosis can affect children, requiring effective treatment options.

Purpose of the Study:

  • To evaluate the feasibility and effectiveness of oral doxycycline in children under 9 years old diagnosed with neuroborreliosis.
  • To assess treatment outcomes, including adverse effects and symptom resolution.

Main Methods:

  • Retrospective study of children under 9 years treated for neuroborreliosis (2019-2023).
  • Data collected on treatment routes, adverse effects, symptom progression, and relapse.
  • Borrelia burgdorferi antibody tests and ICD-10 codes used for patient identification.

Main Results:

  • 54% of children received initial oral doxycycline treatment.
  • Only 6% of those on doxycycline switched to intravenous treatment due to adverse effects or worsening symptoms.
  • 2% experienced photosensitivity rash; no patients had symptom progression or relapse during follow-up (median 41 months).

Conclusions:

  • Oral doxycycline is a feasible and effective treatment for neuroborreliosis in children under 9 years old.
  • The treatment demonstrated a good safety profile with minimal adverse events and no relapses.
Abstract

Keywords:
Borrelia burgdorferiantibiotic stewardshipdoxycyclineneuroborreliosistick‐borne pathogens

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