What is amoxicillin used for. How does amoxicillin work. What are the common side effects of amoxicillin. Who can take amoxicillin. How should amoxicillin be taken. What precautions should be considered when using amoxicillin. How effective is amoxicillin in treating bacterial infections.

Understanding Amoxicillin: A Powerful Antibiotic for Bacterial Infections

Amoxicillin is a widely prescribed penicillin antibiotic used to combat various bacterial infections. This versatile medication plays a crucial role in modern healthcare, offering effective treatment for conditions ranging from common respiratory infections to more severe bacterial invasions.

Typically available in 500 mg tablets or capsules, amoxicillin is also formulated as a liquid suspension for those who have difficulty swallowing pills. While it’s primarily administered orally, in some cases, particularly in hospital settings, it may be given via injection for more rapid absorption and action.

Primary Uses of Amoxicillin

• Chest infections (including pneumonia)
• Dental abscesses
• Ear infections in children
• Stomach ulcers (in combination with other medications)

Is amoxicillin effective against all types of infections? Amoxicillin is specifically designed to target bacterial infections. It’s important to note that it has no effect on viral infections, such as the common cold or flu. This is why healthcare providers often perform tests to confirm a bacterial infection before prescribing amoxicillin.

The Mechanism of Action: How Amoxicillin Fights Bacteria

Amoxicillin belongs to the beta-lactam family of antibiotics, which work by interfering with the cell wall synthesis of bacteria. This mechanism of action is crucial for understanding why amoxicillin is effective against a wide range of bacterial infections.

The Cell Wall Attack

Does amoxicillin kill bacteria immediately? While amoxicillin begins working quickly, it doesn’t instantly eliminate all bacteria. The antibiotic interferes with the formation of peptidoglycan, a crucial component of bacterial cell walls. As bacteria attempt to grow and divide, they become structurally weakened and eventually burst, unable to withstand their internal pressure.

This process takes time, which is why it’s essential to complete the full course of antibiotics as prescribed, even if symptoms improve before the medication is finished. Stopping treatment prematurely can lead to antibiotic resistance and a potential resurgence of the infection.

Dosage and Administration: Ensuring Optimal Efficacy

The correct dosage of amoxicillin is crucial for its effectiveness and safety. While 500 mg tablets are common, the actual prescribed dose can vary based on several factors.

Standard Dosing Guidelines

• Adults: Typically 250mg to 500mg, taken three times a day
• Children: Dosage is usually lower and based on weight

Can amoxicillin be taken with food? Amoxicillin can be taken before or after meals, as food does not significantly affect its absorption. However, taking it with food may help reduce the likelihood of gastrointestinal side effects in some individuals.

Importance of Consistent Timing

For optimal effectiveness, it’s crucial to space doses evenly throughout the day. A common schedule for three-times-daily dosing might be:

1. First dose: Early morning
2. Second dose: Mid-afternoon
3. Third dose: Before bedtime

Are there special instructions for liquid amoxicillin? Liquid formulations should be shaken well before each use. It’s important to use the provided measuring device (usually a syringe or spoon) to ensure accurate dosing, rather than relying on household utensils.

Side Effects and Precautions: Balancing Benefits and Risks

While amoxicillin is generally well-tolerated, like all medications, it can cause side effects in some individuals. Understanding these potential effects is crucial for patients and healthcare providers alike.

Common Side Effects

Do all patients experience side effects from amoxicillin? No, but approximately 1 in 10 people may experience common side effects, including:

• Nausea
• Diarrhea
• Skin rash (in some cases)

These side effects are usually mild and often resolve on their own. However, if they persist or worsen, it’s important to consult a healthcare provider.

Rare but Serious Side Effects

While uncommon, serious side effects can occur in less than 1 in 1,000 people. These may include:

• Severe diarrhea containing blood or mucus
• Signs of liver problems (yellowing of skin or eyes, pale stools, dark urine)
• Unusual bruising or skin discoloration
• Joint or muscle pain occurring after 2 days of treatment

Is it safe to drink alcohol while taking amoxicillin? Unlike some antibiotics, amoxicillin doesn’t typically interact with alcohol. However, it’s generally advisable to avoid alcohol when fighting an infection, as it can slow down the healing process and potentially mask symptoms.

Allergic Reactions: Recognizing and Responding to Amoxicillin Sensitivity

Allergic reactions to amoxicillin, while not extremely common, are a significant concern. Understanding the signs and knowing how to respond is crucial for patient safety.

Prevalence and Manifestations

How common are allergic reactions to amoxicillin? Approximately 1 in 15 people may experience an allergic reaction to amoxicillin. These reactions can range from mild to severe:

• Mild reactions: Often manifest as skin rashes
• Moderate reactions: May include hives or more extensive rashes
• Severe reactions: Can lead to anaphylaxis, a life-threatening emergency

Can an allergic reaction occur after the first dose? Yes, allergic reactions can occur at any time during treatment, even if you’ve taken amoxicillin before without issues. It’s important to be vigilant throughout the course of treatment.

Responding to Allergic Reactions

What should you do if you suspect an allergic reaction to amoxicillin?

1. For mild skin rashes: Contact your healthcare provider. They may recommend antihistamines or switching to a different antibiotic.
2. For severe reactions (difficulty breathing, swelling of face or throat): Seek emergency medical attention immediately.
3. Always inform healthcare providers of any previous allergic reactions to antibiotics.

Special Considerations: Amoxicillin Use in Specific Populations

While amoxicillin is widely used, certain groups require special consideration when prescribing or taking this antibiotic.

Pregnancy and Breastfeeding

Is amoxicillin safe during pregnancy? Amoxicillin is generally considered safe for use during pregnancy and is often the antibiotic of choice when treatment is necessary. However, as with any medication during pregnancy, it should only be used when the potential benefits outweigh the risks.

Can amoxicillin be used while breastfeeding? Amoxicillin is considered compatible with breastfeeding. Small amounts may pass into breast milk, but this is not known to be harmful to most infants. However, it’s always best to consult with a healthcare provider for personalized advice.

Children and Elderly Patients

Amoxicillin is frequently prescribed for children, particularly for ear infections and chest infections. The dosage is typically weight-based, and liquid formulations are often used for ease of administration.

For elderly patients, dosage adjustments may be necessary, particularly if there are underlying kidney or liver issues. Close monitoring for side effects and efficacy is important in this population.

Patients with Liver or Kidney Problems

How does liver or kidney function affect amoxicillin use? Patients with impaired liver or kidney function may require dosage adjustments. These organs play a crucial role in metabolizing and eliminating the drug from the body. Healthcare providers will typically assess liver and kidney function before prescribing amoxicillin and may adjust the dose or frequency of administration accordingly.

Drug Interactions: Navigating Potential Complications

Understanding potential drug interactions is crucial for safe and effective use of amoxicillin. While this antibiotic has fewer interactions compared to some other medications, there are still important considerations.

Common Interactions

• Methotrexate: Amoxicillin may increase the blood levels of methotrexate, potentially leading to increased side effects.
• Allopurinol: Combining this gout medication with amoxicillin may increase the risk of skin rashes.
• Oral contraceptives: In some cases, amoxicillin may reduce the effectiveness of birth control pills.

Does amoxicillin interact with over-the-counter medications? While most over-the-counter medications are safe to take with amoxicillin, it’s always best to consult with a pharmacist or healthcare provider. They can provide personalized advice based on your specific medications and health conditions.

Impact on Diagnostic Tests

Can amoxicillin affect laboratory test results? Yes, amoxicillin can interfere with certain diagnostic tests, potentially leading to false results. This is particularly relevant for:

• Urine glucose tests
• Some types of blood glucose tests
• Tests for urine protein

It’s important to inform healthcare providers about amoxicillin use before undergoing any diagnostic tests to ensure accurate interpretation of results.

Antibiotic Resistance: A Growing Concern in Amoxicillin Use

Antibiotic resistance is a global health challenge, and amoxicillin is not immune to this issue. Understanding the factors contributing to resistance and taking steps to prevent it is crucial for maintaining the effectiveness of this important antibiotic.

Causes of Amoxicillin Resistance

Why do bacteria become resistant to amoxicillin? Several factors contribute to the development of antibiotic resistance:

• Overuse and misuse of antibiotics
• Incomplete treatment courses
• Use of antibiotics in livestock
• Natural bacterial evolution and adaptation

Is amoxicillin still effective against common infections? While resistance is a concern, amoxicillin remains effective for many common bacterial infections. However, its efficacy can vary depending on local resistance patterns and the specific type of infection.

Preventing Resistance

How can patients help prevent antibiotic resistance?

1. Only use amoxicillin when prescribed by a healthcare provider
2. Complete the full course of antibiotics as directed
3. Never share antibiotics or use leftover antibiotics from previous treatments
4. Practice good hygiene to prevent the spread of infections

Healthcare providers play a crucial role in combating resistance by prescribing antibiotics judiciously and educating patients about proper use.

Future Developments: Amoxicillin in the Era of Personalized Medicine

As medical science advances, the approach to antibiotic use, including amoxicillin, is evolving. Personalized medicine and new technologies are shaping the future of bacterial infection treatment.

Tailored Antibiotic Therapy

How might amoxicillin prescribing change in the future? Emerging technologies, such as rapid diagnostic tests and genetic profiling, may allow for more targeted use of amoxicillin. This could involve:

• Quicker identification of bacterial strains
• Personalized dosing based on individual patient factors
• Combination therapies tailored to specific infections

Will new forms of amoxicillin be developed? Research is ongoing into new formulations and delivery methods for amoxicillin, which could enhance its effectiveness or reduce side effects. This may include extended-release formulations or novel combinations with other antimicrobial agents.

The Role of Probiotics

Can probiotics help when taking amoxicillin? There’s growing interest in the use of probiotics alongside antibiotics like amoxicillin. Probiotics may help:

• Reduce antibiotic-associated diarrhea
• Maintain a healthy gut microbiome
• Potentially enhance the effectiveness of antibiotic treatment

While more research is needed, some healthcare providers are already recommending probiotic supplementation during and after amoxicillin treatment.

As we continue to navigate the complex landscape of bacterial infections and antibiotic use, amoxicillin remains a cornerstone of treatment. By understanding its mechanisms, benefits, and potential risks, both healthcare providers and patients can ensure its optimal use, preserving its effectiveness for future generations.

Amoxicillin: antibiotic to treat bacterial infections

1. About amoxicillin

Amoxicillin is a penicillin antibiotic. It is used to treat bacterial infections, such as chest infections (including pneumonia) and dental abscesses. It can also be used together with other antibiotics and medicines to treat stomach ulcers.

It’s often prescribed for children, to treat ear infections and chest infections.

Amoxicillin is only available on prescription. It comes as capsules or as a liquid that you swallow. It’s also given by injection, but this is usually only done in hospital.

2. Key facts

• For most infections, you’ll start to feel better in a few days.
• The most common side effects of amoxicillin are feeling sick (nausea) and diarrhoea.
• Liquid amoxicillin can stain your teeth. This does not last and is removed by brushing.
• You can drink alcohol while taking amoxicillin.
• Sometimes, taking amoxicillin can cause thrush.

3. Who can and cannot take amoxicillin

Amoxicillin can be taken by most adults and children.

Find out more about giving amoxicillin to children on the Medicines for Children website.

Amoxicillin is not suitable for everyone. To make sure amoxicillin is safe for you, tell your doctor if you:

• have ever had an allergic reaction to amoxicillin or penicillin or any other medicine
• have liver or kidney problems
• have recently had, or are due to have, any vaccinations

4. How and when to take amoxicillin

Dosage

The usual dose of amoxicillin capsules is 250mg to 500mg, taken 3 times a day. The dose may be lower for children.

Amoxicillin liquid is available in 125mg and 250mg doses.

Important

Carry on taking this medicine until you’ve completed the course, even if you feel better. If you stop your treatment early, the infection could come back.

How to take it

Try to space the doses evenly throughout the day. If you take it 3 times a day, this could be first thing in the morning, mid-afternoon and at bedtime.

You can take amoxicillin before or after food.

Swallow amoxicillin capsules whole with a drink of water. Do not chew or break them.

Amoxicillin is available as a liquid for children and people who find it difficult to swallow capsules.

If you or your child are taking liquid amoxicillin, it will usually be made up for you by your pharmacist. The medicine will come with a plastic syringe or spoon to help you measure out the right dose. If you do not have one, ask your pharmacist for one. Do not use a kitchen teaspoon as it will not measure the right amount.

If you forget to take it

If you forget to take a dose, take it as soon as you remember, unless it’s nearly time for your next dose. In this case, just leave out the missed dose and take your next dose at the usual time.

Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.

If you forget doses often, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicines.

If you take too much

Taking an extra dose of amoxicillin is unlikely to harm you or your child, but speak to your pharmacist or doctor if you’re worried.

Urgent advice: Contact 111 for advice now if:

You have taken more than your prescribed dose of amoxicillin and have symptoms including:

• stomach pain or you’re being sick
• blood in your pee
• difficulty peeing or producing less pee than usual

Go to 111.nhs.uk or call 111

5. Side effects

Like all medicines, amoxicillin can cause side effects, although not everyone gets them.

Common side effects

These common side effects happen in around 1 in 10 people. Keep taking the medicine, but talk to your doctor or pharmacist if these side effects bother you or do not go away:

• feeling sick (nausea)
• diarrhoea

Serious side effects

Serious side effects are rare and happen in less than 1 in 1,000 people.

Call a doctor or call 111 now if you get:

• diarrhoea (possibly with stomach cramps) that contains blood or mucus or severe diarrhoea that lasts for more than 4 days
• pale poo and dark pee, and the whites of your eyes or your skin turn yellow (although this may be less obvious on brown or black skin) – these can be signs of liver or gallbladder problems
• bruising or changes in your skin colour
• joint or muscle pain that comes on after 2 days of taking the medicine
• a skin rash with circular red patches (this may be less obvious on brown or black skin)

Some of these serious side effects can happen up to 2 months after finishing the amoxicillin.

Serious allergic reaction

Around 1 in 15 people have an allergic reaction to amoxicillin.

In most cases, the allergic reaction is mild and can take the form of a skin rash.

Mild skin rashes can usually be treated by taking antihistamines.

In rare cases, amoxicillin can cause a serious allergic reaction (anaphylaxis).

Immediate action required: Call 999 or go to A&E now if:

• you get a skin rash that may include itchy, red, swollen, blistered or peeling skin
• you’re wheezing
• you get tightness in the chest or throat
• you have trouble breathing or talking
• your mouth, face, lips, tongue or throat start swelling

You could be having a serious allergic reaction and may need immediate treatment in hospital.

These are not all the side effects of amoxicillin. For a full list, see the leaflet inside your medicines packet.

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

6. How to cope with side effects of amoxicillin

What to do about:

• feeling sick – stick to simple meals and do not eat rich or spicy food. It might help to take your amoxicillin after a meal or snack.
• diarrhoea – drink plenty of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark, strong-smelling pee. Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor. If you take contraception and you have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Check the pill packet to find out what to do.

7. Pregnancy and breastfeeding

Amoxicillin and pregnancy

It is safe to take amoxicillin during pregnancy.

Amoxicillin and breastfeeding

It is OK to take amoxicillin while breastfeeding. Information shows that only tiny amounts of amoxicillin get into breast milk. Such levels would not be expected to cause side effects in your baby.

Talk to your doctor, pharmacist, health visitor or midwife if:

• your baby is not feeding as well as usual
• they have sickness or diarrhoea
• your baby has oral thrush, or a skin rash
• you have any other concerns about your baby

For more information about how amoxicillin can affect you and your baby during pregnancy, visit the Best Use of Medicines in Pregnancy (BUMPS) website.

8. Cautions with other medicines

There are some medicines that do not mix well with amoxicillin.

Tell your doctor if you’re taking any of these medicines before you start taking amoxicillin:

• methotrexate, used to treat arthritis and psoriasis
• warfarin, a medicine to prevent blood clots
• gout medicines called probenecid or allopurinol
• other antibiotics

Tell your doctor if you’ve recently had, or are due to have, an oral typhoid vaccine. Amoxicillin can make it less effective.

Mixing amoxicillin with herbal remedies and supplements

There is little information about taking herbal remedies and supplements alongside amoxicillin.

Important:
Medicine safety

Tell your doctor or pharmacist if you’re taking any other medicines, including herbal medicines, vitamins or supplements.

9. Common questions about amoxicillin

How does amoxicillin work?

Amoxicillin is a penicillin antibiotic. It works by killing the bacteria that cause the infection.

When will I feel better?

For most infections, you should feel better within a few days.

It’s very important that you keep taking amoxicillin until your course is finished. Do this even if you feel better. It will help stop the infection coming back.

What if I do not get better?

Tell your doctor if you do not start feeling better after taking amoxicillin for 3 days. Also tell them if, at any time, you start to feel worse.

Will it give me thrush?

Some people get a fungal infection called thrush after taking a course of antibiotics like amoxicillin. If you think you have thrush, speak to your pharmacist or ask your doctor for advice.

How does amoxicillin compare with other antibiotics?

Amoxicillin and other penicillins, like phenoxymethylpenicillin, are antibiotics that are widely used to treat a variety of infections, including skin, dental, throat and chest infections.

Not all antibiotics are suitable for every infection. Your doctor will choose an antibiotic that’s suitable for the type of infection you have. Speak to your pharmacist or doctor if you have any questions.

Will it affect my contraception?

Amoxicillin does not stop contraceptive pills working, including the combined pill or emergency contraception.

However, if amoxicillin makes you sick (vomit) or have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy. Check the pill packet to find out what to do.

Find about more about what to do if you’re on the pill and you’re being sick or have diarrhoea.

Will it affect my fertility?

There’s no evidence to suggest that taking amoxicillin reduces fertility in either men or women.

Does it stain teeth?

If you or your child take amoxicillin as a liquid medicine, it can stain your teeth. This does not last and should go after brushing your teeth well.

Amoxicillin capsules do not stain teeth.

Can I drive or ride a bike?

Yes. Amoxicillin should not affect you being able to drive or cycle.

Is there any food or drink I need to avoid?

You can eat and drink normally while taking amoxicillin.

Can I drink alcohol with it?

Yes, you can drink alcohol with amoxicillin.

Amoxicillin Pill Images – What does amoxicillin look like?

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What does Amoxicillin look like?

Note: Multiple pictures are displayed for those medicines available in different strengths, marketed under different brand names and for medicines manufactured by different pharmaceutical companies. Multi ingredient medications may also be listed when applicable.
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Medical Disclaimer

Amoxicillin – Together by St. Jude

Antibiotic

Trademarks:

Moxatag®, Amoxil®

Other names:

p-Hydroxyampicillin

Often used for:

Infections

Amoxicillin is an antibiotic. Its action is aimed at the destruction of bacteria that cause infections. Amoxicillin is an antibiotic of the penicillin group. Amoxicillin is available in various dosage forms. Follow dosage instructions carefully.

Oral chewable tablets

Oral capsules

Oral liquid form

• Diarrhea
• Nausea and vomiting
• Headache
• Abdominal pain
• Taste disturbance

Symptoms of an allergic reaction may occur: rash, hives, itching, chills, fever, headache, muscle pain, shortness of breath, cough, tightness in the throat, swelling of the face or neck

The listed side effects are not observed in all patients who are prescribed amoxicillin. The most common side effects are highlighted in bold, but others are not excluded. Report all possible side effects to your doctor or pharmacist.

Be sure to discuss these and other recommendations with your doctor or pharmacist.

• Tell your doctor if you have severe diarrhea while taking this drug.
• It is important to drink plenty of fluids while taking the drug. Drink the amount of fluid recommended by your doctor.
• Amoxicillin may interfere with some laboratory tests, especially in patients with high blood sugar (diabetes). Ask your doctor or pharmacist how to properly use the urine glucose test strips and how to interpret the results.
• Amoxicillin may increase or decrease the effectiveness of other medicines. Tell your doctor or pharmacist about all medicines you are taking, especially if it is methotrexate or probenecid.
• Pregnant or breastfeeding patients should notify their physician.
• The use of amoxicillin may reduce the effectiveness of birth control pills and other hormonal methods of contraception. During therapy, patients who are sexually active should use other methods of contraception, such as condoms.
• The course of taking the drug must be completed completely in accordance with the recommendations of the attending physician or pharmacist.

Taking amoxicillin at home:

• It should be taken at the same time every day.
• Long-acting tablets: must be swallowed whole. It is not allowed to break, grind or chew them before taking. The extended-release tablets should be taken within 1 hour after a meal.
• Amoxicillin in other dosage forms can be taken with or without food. If the drug causes stomach upset, it must be taken with food.
• In liquid form: shake well before use, use the measuring device provided to measure the dosage. The drug in liquid form can be mixed with milk, juice, water or other cool drinks immediately before taking.
• Chewable tablet should be chewed or broken before swallowing.
• Take your dose as soon as possible if you miss it. Do not do this only if there is little time left until the next appointment. In no case do not double the dose at the next dose!
• Store amoxicillin at room temperature.
• Liquid amoxicillin may be stored at room temperature or in the refrigerator. After opening, store no more than 14 days.
• Do not use an expired drug.
• Follow instructions for safe storage and disposal of the drug.

More about amoxicillin

Tick-borne borreliosis (Lyme disease) – symptoms, diagnosis and treatment

Infectious pathology proceeds according to the standard algorithm, which includes 3 stages, corresponding to the peculiarities of pathogenesis. Stages I and II are conventionally combined into the early phase of infection, and stage III represents the late phase of the disease. Each of the stages of Lyme borreliosis has a special symptom complex. In a separate category, a latent form is distinguished, in which there are no clinical signs, but the pathogen is in the body.

Stage I

At the initial stage, a person experiences signs of general intoxication: fever, chills, headaches and body aches occur. Less common are sore throat, dry cough and runny nose. Intense muscle pain and stiffness of the neck muscles are possible. The symptoms are similar to the flu and other respiratory infections.

The pathognomonic sign of borreliosis is erythema migrans annulare (ME), which manifests itself at the site of a tick bite. First, a red spot appears, which increases in size within a few days. Its edges remain bright red and slightly swollen, and the center turns pale, which is why the redness looks like a ring. The condition is accompanied by an increase in the lymph nodes, which are located near the bite. ME has a diameter of up to 20 cm, in rare cases it reaches a size of 50-60 cm. Redness is most often located on the legs, in the axillary and inguinal regions. If there have been several tick bites, a corresponding number of annular elements may occur. Erythema persists for 2-3 weeks, after which it disappears through the stage of residual pigmentation and desquamation.

In 30% of patients, the symptoms of tick-borne borreliosis are not accompanied by the appearance of ME. In this case, a small inflamed area is formed at the site of suction of the parasite. Occasionally, the disease is accompanied by benign lymphoplasia of the skin, which is also called lymphocytoma. It is manifested by painful bluish-red nodes, which are mainly localized on the face, around the mammary glands, in the genital area. Reactive lymphoproliferation persists for several months and resolves spontaneously.

The duration of stage I is 3-30 days. With the timely start of treatment, it is possible to completely remove the symptoms and eliminate negative long-term consequences. If therapy has not been carried out, the disease passes to stage II of development.

Stage II

Symptoms of the second stage of the disease occur in 10-15% of patients. This stage proceeds with the involvement of 3 body systems: nervous, cardiovascular, osteoarticular. In typical cases, borreliosis is manifested by the pathology of one of the 3 above-mentioned systems, but occasionally combined pathologies develop.

When the nervous system is involved in the process, the following symptoms of borreliosis occur:

1. Meningitis and meningoencephalitis. Infectious damage to the brain is manifested by severe headaches, repeated vomiting, increased susceptibility to bright light and loud sounds. Characterized by soreness of the occipital muscles, pain when moving the eyes. About a third of patients complain of drowsiness during the day and constant insomnia at night, memory impairment, emotional instability.
2. Neuritis of the cranial nerves. Most often, with Lyme borreliosis, the facial nerves are affected, which is accompanied by numbness of half of the face, drooping of the corner of the mouth, and speech disorders. Less often, the oculomotor, abducens, and optic nerves are involved in the process, which leads to complex disorders in the work of the visual analyzer.
3. Bannwart’s meningoradiculoneuritis. This is a disease specific to tick-borne borreliosis, in which the patient has a combination of signs of meningitis, damage to the cranial nerves and roots extending from the spinal cord. In addition to typical meningeal signs, intense pain in the neck and chest, paresis and paralysis of skeletal muscles, impaired coordination of movements and the ability to maintain balance develop.

Cardiovascular pathologies are registered in 10% of patients after 5-6 weeks from the onset of the infectious symptom complex. They are represented by pain in the left side of the chest, increased heart rate, a feeling of fading and interruptions in the work of the heart. Shortness of breath and dizziness caused by circulatory failure are also observed. In severe cases, pericarditis, myocarditis, dilated cardiomyopathy are possible.

Lyme disease typically involves the musculoskeletal system. Lyme arthritis occurs with damage to the large joints of the body as arthralgia, recurrent benign or chronic arthritis. These forms can pass into each other or appear in isolation. A feature of arthritis is inflammation of one or two large joints, in contrast to rheumatoid diseases, which primarily affect small joints and are characterized by symmetrical inflammation. The differential signs of Lyme arthritis include the same intensity of pain and stiffness, which does not depend on the time of day and the patient’s physical activity. Symptoms have an undulating course with periods of exacerbation lasting from several days to several weeks.

More rare symptoms include:

• red rash on palms;
• rashes in the form of wheals;
• benign skin lymphocytoma;
• myositis;
• generalized lymphadenopathy;
• hepatitis;
• jade;
• bronchitis;
• orchitis in men.