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 taken when using amoxicillin. How effective is amoxicillin in treating bacterial infections.

Understanding Amoxicillin: A Versatile Antibiotic

Amoxicillin is a widely prescribed penicillin antibiotic used to combat various bacterial infections. This powerful medication plays a crucial role in modern healthcare, effectively treating conditions ranging from common chest infections to more severe cases of pneumonia and dental abscesses.

Is amoxicillin suitable for children? Indeed, it’s frequently prescribed for pediatric patients, particularly for ear infections and chest infections. However, the dosage for children is typically lower than that for adults.

Key Facts About Amoxicillin

• Available only by prescription
• Comes in capsule form or as a liquid for oral consumption
• Can be administered via injection in hospital settings
• Generally starts showing effects within a few days of treatment
• May cause teeth staining when taken in liquid form (temporary and removable by brushing)
• Can be taken alongside alcohol
• Occasionally may lead to thrush

Dosage and Administration of Amoxicillin

How much amoxicillin should be taken? The standard dosage for adults is typically 250mg to 500mg, administered three times daily. For liquid amoxicillin, concentrations of 125mg and 250mg are available.

When should amoxicillin be taken? It’s crucial to space the doses evenly throughout the day. For a three-times-daily regimen, this could mean taking it in the morning, mid-afternoon, and before bed. Amoxicillin can be taken with or without food.

Important Administration Guidelines

1. Swallow capsules whole with water, avoiding chewing or breaking
2. For liquid form, use the provided measuring device for accurate dosing
3. Continue the full course of treatment, even if symptoms improve
4. If a dose is missed, take it as soon as remembered, unless it’s close to the next scheduled dose
5. Never double up on doses to make up for a missed one

Side Effects and Precautions of Amoxicillin Use

Are there common side effects associated with amoxicillin? Yes, like all medications, amoxicillin can cause side effects, though not everyone experiences them. The most frequent side effects, occurring in about 1 in 10 people, include nausea and diarrhea.

Serious Side Effects to Watch For

While rare, 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 or gallbladder problems (pale stools, dark urine, yellowing of skin or eyes)
• Unexplained bruising or skin color changes
• Joint or muscle pain developing after 2 days of treatment
• Skin rash with circular red patches

Can amoxicillin cause allergic reactions? Approximately 1 in 15 people may experience an allergic reaction to amoxicillin. Most cases are mild, manifesting as a skin rash treatable with antihistamines. However, in rare instances, severe allergic reactions can occur.

Who Can Take Amoxicillin?

While amoxicillin is suitable for most adults and children, certain individuals should exercise caution. Who should avoid taking amoxicillin? Inform your healthcare provider if you:

• Have a history of allergic reactions to amoxicillin, penicillin, or other medications
• Suffer from liver or kidney problems
• Have recently received or are scheduled for vaccinations

Amoxicillin’s Mechanism of Action

How does amoxicillin combat bacterial infections? As a member of the penicillin family, amoxicillin works by interfering with the cell wall synthesis of bacteria. This action weakens the bacterial structure, ultimately leading to cell death and halting the infection’s progression.

Spectrum of Activity

Amoxicillin is effective against a wide range of bacteria, including:

• Streptococcus pneumoniae (common cause of pneumonia)
• Haemophilus influenzae (responsible for some respiratory infections)
• Escherichia coli (a frequent culprit in urinary tract infections)
• Helicobacter pylori (when used in combination therapy for stomach ulcers)

Potential Drug Interactions with Amoxicillin

Can amoxicillin interact with other medications? Yes, amoxicillin may interact with certain drugs, potentially affecting their efficacy or increasing the risk of side effects. It’s crucial to inform your healthcare provider about all medications you’re currently taking, including over-the-counter drugs and supplements.

Notable Drug Interactions

• Methotrexate: Amoxicillin may increase methotrexate levels in the blood
• Allopurinol: Concurrent use may increase the risk of skin rash
• Oral contraceptives: Amoxicillin may reduce their effectiveness
• Warfarin and other blood thinners: Amoxicillin may enhance their anticoagulant effect

Amoxicillin in Pregnancy and Breastfeeding

Is amoxicillin safe during pregnancy and breastfeeding? Generally, amoxicillin is considered safe for use during pregnancy and while breastfeeding. However, it’s essential to consult with a healthcare provider before using any medication during these periods.

Considerations for Pregnant Women

Amoxicillin crosses the placenta but has not been associated with an increased risk of birth defects. It’s classified as FDA Pregnancy Category B, indicating no evidence of risk in humans.

Breastfeeding Considerations

Small amounts of amoxicillin can pass into breast milk. While this is generally not harmful to the nursing infant, it’s important to monitor for potential side effects such as diarrhea or rash in the baby.

Antibiotic Resistance and Amoxicillin

What is antibiotic resistance, and how does it relate to amoxicillin? Antibiotic resistance occurs when bacteria evolve to withstand the effects of antibiotics, making infections harder to treat. The overuse and misuse of antibiotics, including amoxicillin, contribute to this growing global health concern.

Preventing Antibiotic Resistance

• Complete the full course of antibiotics as prescribed
• Do not save antibiotics for future use or share them with others
• Use antibiotics only when necessary and as directed by a healthcare professional
• Practice good hygiene to prevent the spread of infections

How can healthcare providers help combat antibiotic resistance? By judiciously prescribing antibiotics, educating patients on proper use, and considering alternative treatments when appropriate, healthcare professionals play a crucial role in mitigating the spread of antibiotic-resistant bacteria.

Amoxicillin vs. Other Antibiotics

How does amoxicillin compare to other commonly prescribed antibiotics? While amoxicillin is highly effective for many bacterial infections, it’s not always the best choice. Let’s examine how it stacks up against some other popular antibiotics:

Amoxicillin vs. Penicillin

Both belong to the penicillin family, but amoxicillin has a broader spectrum of activity. It’s often preferred for its improved absorption and effectiveness against a wider range of bacteria.

Amoxicillin vs. Azithromycin

Azithromycin belongs to a different class of antibiotics (macrolides) and is often used for respiratory infections. It typically requires a shorter course of treatment compared to amoxicillin.

Amoxicillin vs. Ciprofloxacin

Ciprofloxacin, a fluoroquinolone antibiotic, is effective against a broader range of bacteria, including some that may be resistant to amoxicillin. However, it also carries a higher risk of serious side effects.

Future Developments in Antibiotic Therapy

What does the future hold for antibiotics like amoxicillin? As antibiotic resistance continues to pose challenges, researchers are exploring various avenues to enhance the effectiveness of existing antibiotics and develop new treatment strategies.

Promising Areas of Research

• Combination therapies: Using multiple antibiotics or combining antibiotics with other compounds to enhance their efficacy
• Nanoparticle delivery systems: Improving the targeted delivery of antibiotics to infection sites
• Bacteriophage therapy: Utilizing viruses that specifically target bacteria as an alternative or complement to traditional antibiotics
• CRISPR technology: Exploring gene-editing techniques to combat antibiotic-resistant bacteria

How might these developments impact the use of amoxicillin in the future? While amoxicillin will likely remain a valuable tool in fighting bacterial infections, these advancements could lead to more targeted and effective use, potentially reducing the risk of antibiotic resistance.

Amoxicillin in Veterinary Medicine

Is amoxicillin used in animals? Yes, amoxicillin is widely used in veterinary medicine to treat various bacterial infections in pets and livestock. However, its use in animals has raised concerns about contributing to antibiotic resistance that could affect human health.

Veterinary Applications of Amoxicillin

• Treatment of respiratory infections in cats and dogs
• Management of skin infections in various animal species
• Control of bacterial infections in livestock
• Prevention of infections in high-risk animals

What precautions are taken to prevent antibiotic resistance from veterinary use? Many countries have implemented regulations to restrict the use of antibiotics in animals, particularly those that are important in human medicine. These measures include:

• Requiring veterinary prescriptions for antibiotic use in animals
• Prohibiting the use of certain antibiotics for growth promotion in livestock
• Encouraging alternative management practices to reduce the need for antibiotics
• Promoting responsible use guidelines for veterinarians and farmers

Environmental Impact of Amoxicillin Use

Does the widespread use of amoxicillin affect the environment? The increasing use of antibiotics, including amoxicillin, has raised concerns about their impact on ecosystems and wildlife. Antibiotics can enter the environment through various routes, including human and animal excretion, improper disposal of unused medications, and pharmaceutical manufacturing waste.

Environmental Consequences

• Alteration of microbial communities in soil and water
• Potential development of antibiotic-resistant bacteria in the environment
• Effects on aquatic organisms and potential bioaccumulation in the food chain
• Disruption of nutrient cycling processes in ecosystems

How can we mitigate the environmental impact of amoxicillin and other antibiotics? Several strategies can help reduce the environmental footprint of antibiotic use:

• Proper disposal of unused medications through take-back programs
• Improving wastewater treatment processes to remove antibiotics
• Reducing unnecessary antibiotic use in humans and animals
• Developing more environmentally friendly antibiotic alternatives
• Implementing stricter regulations on pharmaceutical waste management

Global Access to Amoxicillin and Health Disparities

Is access to amoxicillin equal worldwide? Despite being on the World Health Organization’s List of Essential Medicines, access to amoxicillin varies significantly across different regions and socioeconomic groups. This disparity in access contributes to global health inequalities and challenges in managing infectious diseases.

Factors Affecting Global Access

• Economic barriers and healthcare infrastructure
• Supply chain issues and quality control challenges
• Regulatory differences between countries
• Cultural and educational factors influencing antibiotic use

How can global access to amoxicillin be improved? Addressing this issue requires a multifaceted approach:

• International cooperation to ensure affordable pricing and distribution
• Strengthening healthcare systems in low- and middle-income countries
• Promoting local production of high-quality generic antibiotics
• Implementing educational programs on appropriate antibiotic use
• Developing innovative delivery methods for remote or underserved areas

By improving global access to essential antibiotics like amoxicillin while promoting responsible use, we can work towards better health outcomes and reduced disparities in infectious disease management worldwide.

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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Further information

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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.