Guidance

Lyme disease: management and prevention

How to reduce the risk of Lyme disease, its clinical management and other useful resources.

Clinical management

If recognised promptly and treated with a full course of appropriate antibiotics, acute Lyme disease will usually resolve without further complications. Therefore it is important to treat patients presenting with an erythema migrans rash on clinical suspicion alone and to recognise other manifestations of Lyme disease and investigate accordingly.

The NICE Lyme disease guideline gives detailed advice for healthcare professionals about the treatment of Lyme disease

The antibiotic choices recommended by NICE for treating Lyme disease are summarised in this useful infographic, produced by the BMJ.

Post exposure prophylaxis is only recommended in areas of very high Lyme disease incidence such as the eastern seaboard of the USA and is not recommended anywhere else.

Transmission and prevention

There are no known cases of transmission of Lyme disease by vectors other than ticks and there is no reliable documented evidence of transmission by person-to-person contact.

The risk of mother to baby transmission is very low. See the NICE guideline section ‘Management for women with Lyme disease during pregnancy and their babies’.

There are no vaccines for Lyme disease prevention currently available for human use.

The best way to reduce the chance of getting Lyme disease is to improve tick awareness, reduce the risk of tick bites and to remove any attached tick quickly and correctly.

The UK Health Security Agency (UKHSA) provides several resources about tick awareness and how to reduce the risk of Lyme disease.

Tick bite risks and prevention of Lyme disease: resources

Other resources

UKHSA’s advice for the public and patients is available on NHS.UK and in a UKHSA leaflet about Lyme disease signs and symptoms.

Lyme disease: signs and symptoms

Support and advice is also available from Lyme Disease Action.

A Lyme disease e-learning course for general practitioners is available from the Royal College of General Practitioners and Lyme Disease Action.

Systematic reviews on the prevalence, diagnosis, treatment and prevention of Lyme disease, commissioned by the Department of Health and Social Care.

Published 31 July 2018
Last updated 14 April 2022 + show all updates
  1. Updated guidance.

  2. First published.