| Appropriate antibiotic therapy should be initiated immediately when there is suspicion of Rocky Mountain spotted fever, ehrlichiosis, or relapsing fever rather than waiting for laboratory confirmation. | C | 7 |
| Treatment with doxycycline (Vibramycin) or tetracycline is recommended for Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, and relapsing fever. | C | 7,16,20 |
| Recommended actions to prevent tick-borne disease include avoidance of tick-infested areas; wearing long pants and tucking the pant legs into socks; applyingN,N-diethyl-m-toluamide (DEET) insect repellents; using bed nets when camping; and carefully inspecting oneself frequently while in an at-risk area. | C | 16 |
| Antibiotic prophylaxis is not routinely recommended for a tick bite to prevent Lyme disease unless the risk of infection is high. | B | 16,17 |
| Recommended treatment for suspected tularemia is streptomycin or gentamicin given empirically before evidence of laboratory confirmation. | C | 24 |