For a patient with Lyme disease presenting with a rash, joint pain, or Bell's palsy, what is the appropriate first-line treatment?

The appropriate first-line treatment for Lyme disease, particularly when the patient presents with conditions such as rash, joint pain, or Bell's palsy, is doxycycline or amoxicillin. These antibiotics are effective against the bacterium Borrelia burgdorferi, which causes Lyme disease.

Doxycycline is often preferred due to its efficacy, ease of dosing, and the added benefit of treating co-existing infections like anaplasmosis, especially in endemic areas. However, amoxicillin is a suitable alternative for patients who may have contraindications to doxycycline, such as pregnant women or young children.

Using either doxycycline or amoxicillin promptly addresses the bacterial infection and helps prevent potential complications associated with Lyme disease. Starting treatment early is crucial in reducing symptoms and preventing the progression to more serious manifestations.

Other options like IV ceftriaxone would be more appropriate for patients with severe or refractory cases, such as those with neurological manifestations requiring a more aggressive approach. Clindamycin and quinine are not standard treatments for Lyme disease. Clindamycin is ineffective against Borrelia, while quinine is used for malaria but has no role in the treatment of Lyme disease. Thus, doxycycline or amoxicillin remains the