Which antibiotic is preferred for Lyme disease in pregnancy or children?

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Lyme disease treatment in pregnancy or young children prioritizes safety for the fetus and developing child, while still providing effective therapy. Doxycycline is avoided in these groups because tetracyclines can affect teeth and bone development, causing permanent teeth staining and growth concerns. Amoxicillin, on the other hand, is safe in pregnancy and in young children and remains reliably active against Borrelia burgdorferi, making it the preferred choice in this setting. Azithromycin has lower efficacy and higher failure rates, so it isn’t considered first-line. Cefuroxime can be used if amoxicillin isn’t suitable, but amoxicillin is typically preferred when possible.