Ixodes scapularis, commonly referred to as the deer tick, is the vector of Lyme disease and anaplasmosis; both illnesses are endemic to the upper Midwest. Avoidance of I scapularis bites is the primary preventative strategy for both infections. Antibiotic prophylaxis has been demonstrated to prevent Lyme disease, but similar studies have not investigated antibiotic prophylaxis for the prevention of anaplasmosis. Thus, recommendations regarding the management of I scopularis bites are focused on the prevention of Lyme disease. This paper reviews the prevailing antibiotic prophylaxis recommendation for Lyme disease and the evidence supporting it. Given the additional risk of acquiring anaplasmosis from an I scapularis bite in the upper Midwest, this paper proposes an alternative regimen for antibiotic prophylaxis in this region.