Which antibiotic is contraindicated in pregnancy for Lyme disease?

• A. Doxycycline
• B. Ceftriaxone
• C. Amoxicillin
• D. Azithromycin

Answer: (A)

Doxycycline is avoided in pregnancy because tetracyclines cross the placenta and bind to calcium in the developing teeth and bones, leading to permanent enamel staining and potential effects on fetal bone growth. For Lyme disease in pregnancy, safer options include amoxicillin or a cephalosporin (such as cefuroxime), with intravenous ceftriaxone reserved for more severe cases. Azithromycin isn’t a preferred choice due to limited efficacy against Borrelia. So the antibiotic that should not be used in pregnancy for Lyme disease is doxycycline.