Doctors Clash Over Best Treatments for Lyme Disease.
The Centers for Disease Control and Prevention stands by the IDSA guidelines. Dr. Paul Mead, chief of epidemiology and surveillance activity at the CDC’s bacterial-diseases branch, tells the Health Blog that could change if more contrary evidence emerges.
Excerpted from Wall Street Journal ( Posted: 03/27/2012)
As tick-borne illnesses continue to spread, a long-running dispute between two groups of medical professionals over how best to treat Lyme disease continues to simmer.
As WSJ reports in today’s Informed Patient column, efforts are underway to prevent people and their pets from picking up illnesses that ticks carry, led by Lyme, which is most common in 12 states, primarily in the Northeast, but is expanding across the U.S.
Patients may have a rash that looks like a bull’s eye; once Lyme is diagnosed using blood tests and a physical exam, guidelines from the Infectious Diseases Society of America call for standard treatment of a two-week course of antibiotic, with one or two antibiotic courses lasting four weeks each recommended only for certain late-stage types of the disease such as a form of Lyme arthritis.
But another group, the International Lyme and Associated Diseases Society, says Lyme may become chronic, and its guidelines say continuing treatment for several months or even longer for those patients is reasonable.
The IDSA guidelines were the subject of an antitrust investigation in 2006 by Connecticut’s then attorney general and current U.S. Sen. Richard Blumenthal, who examined whether the authors had conflicts of interest and failed to consider divergent medical opinions.
As part of an agreement to end the probe, IDSA voluntarily agreed to a review of the guidelines by an independent scientific panel. In 2010, the group reported that no changes needed to be made, that there is no convincing evidence for the existence of chronic Lyme infection, and that long-term antibiotic treatment of what some doctors describe as “chronic Lyme disease” is unproven and unwarranted.