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

Objective: There is limited evidence on the use of oral doxycycline in young children. We evaluated the feasibility and effectiveness of doxycycline in children under 9 years with neuroborreliosis.

Methods: This retrospective study included all children under 9 years of age treated for neuroborreliosis in the Capital Region of Denmark from 2019 to 2023. Patients were identified through Borrelia burgdorferi antibody tests and International Classification of Disease, 10th revision codes. Outcomes were change of treatment route, intolerable adverse effects of oral doxycycline, progression of symptoms after treatment cessation, continuous symptoms of neuroborreliosis exceeding 6 months, and relapse of neuroborreliosis.

Results: Of 116 children, 63 (54%) received doxycycline initially, 4 (6%) of whom switched to intravenous treatment due to adverse effects or symptom worsening during treatment. Of 46 (40%) receiving intravenous antibiotics followed by doxycycline, 45 (98%) completed the remaining treatment on doxycycline. Seven (6%) patients received intravenous antibiotics only. Of 109 patients receiving doxycycline, two (2%) experienced photosensitivity rash. Symptoms lasting over 6 months were observed in two patients. No patients had symptom progression or relapse during the follow-up period (median 41 months, range 12-66).

Conclusions: Oral doxycycline was effective and feasible in children under 9 years with neuroborreliosis.