The top doctor in Sweden for treatment of advanced Lyme disease has been suspended from practicing medicine, leaving hundreds of patients without care in a country with a large and growing problem of tick-borne disease.
The physician, Kenneth Sandström, said the action was taken because he treated patients with longer courses of antibiotics than recommended by prevailing treatment guidelines.
Sandström is a seasoned general practitioner who treated his first Lyme disease case about five years ago, when a registered nurse who had been diagnosed with multiple sclerosis asked him to treat her for possible Lyme disease. He studied the scientific literature for several months – he at first thought the idea was “rubbish” — then put her on four months of antibiotics.
“Twenty years of MS was gone,” he told me at a conference in Philadelphia last November when he was facing disciplinary charges. He acknowledged that other cases were not as “easy” but said he saw overall and sometimes-dramatic improvement from longer antibiotic treatment. “You have to accept this is something,” he said.
‘For patients, it’s a catastrophe.’ — Janna Strandli, president of the Swedish Lyme Disease Association
More than 6,000 people signed an online petition and 400 patients left messages of support when his disciplinary action was announced in 2014. People with Lyme disease and their advocates were devastated by the news of Sandström’s suspension.
“For the patients this means they have to turn to doctors abroad to get treatment, and for those who can’t afford this or are too ill to travel, it’s a catastrophe,” said Janna Strandli, president of the Swedish Lyme Disease Association. “Dr. Sandström has helped so many patients to regain their health and hope to get well again.”
In an email after the licensing board’s decision, Dr. Sandström said the suspension was based on charges related to prescribing the antibiotic Rifampicin to 13 patients, all of whom Sandström said got better. The suspension was not for a set amount of time; Sandström said he would appeal.
Southern Sweden has Western Europe’s highest rate of Lyme disease at 464 cases per 100,000 residents, according to published research, rivaling rates in the U.S. Northeast. In Sweden, a warming climate has helped push diseased ticks about 300 miles further north in recent years, part of a global trend that I will write about in an upcoming book.
Dr. Sandström’s case demonstrates the worldwide influence of Lyme treatment guidelines developed in the United States by the Infectious Diseases Society of America. Those guidelines, which generally limit antibiotic courses to 10 to 28 days, were removed last year from the National Guidelines Clearinghouse because they had not been updated since 2006. Currently, the NGC has approved posting the guidelines of the International Lyme and Associated Diseases Society, which recommend longer and, for potentially chronic cases of disease, repeated rounds of antibiotics, and which Sandström said he followed.