Although experts recommend clinicians consider doxycycline for the treatment of Lyme meningitis and Lyme carditis, the drug does carry the risk of complications. A recent retrospective cohort study conducted at Children’s Hospital of Philadelphia has concluded that oral doxycycline is less likely to cause adverse effects than parenteral administration of the drug.

• The rate of complications among 138 hospitalized children with disseminated Lyme disease who received parenteral antibiotics was 15.4/1,000 days of therapy, compared to 4.2/1,000 days for oral administration.
• The study also found that oral therapy for disseminated Lyme disease was no more likely to result in treatment failure, when compared to IV therapy.
• Documented treatment related complications for Lyme disease, which included patients with meningitis, arthritis, carditis, multiple erythema, and hospital readmission, were PICC complications, IgE and non-IgE reactions, and gastrointestinal effects.