ILADS
Lyme Disease Treatment Guidelines
Summary
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In
early 2004, The International Lyme and Associated Diseases Society
(ILADS) released the first evidence-based comprehensive set
of Lyme Disease Treatment Guidelines to assist physicians, public
health officials and organizations involved in the evaluation
and treatment of Lyme disease. The Lyme Disease Association
(national) and the California Lyme Disease Association endorsed
the Guidelines which were then peer-reviewed and made available
to professionals and to the public.
Lyme is the number
one tick-borne illness in the US. The CDC reports there are 24,000 new
cases of Lyme disease in the US but the CDC says that figure could be
under reported by tenfold. ILADS believes newly diagnosed cases of Lyme
may occur at a rate five times higher than the number of new AIDS cases.
Chronic Lyme is reported in up to half of patients treated for Lyme.
ILADS Lyme Treatment
Guidelines suggest more aggressive treatment for people at risk. A short
summary of ILADS’ recommendations includes:
- Treatment for
symptomatic presentations
- Treatment should
not be withheld based on laboratory testing
- Early use of
antibiotics
- Longer courses
of antibiotics treatment
- Repeat antibiotics
for recurrence
Symptomatic Presentations
of Lyme Disease include:
- Fatigue
- Low grade fevers,
“hot flashes” or chills
- Night sweats
- Sore throat
- Swollen glands
- Stiff neck
- Migrating arthralgias,
stiffness and frank arthritis
- Myalgia
- Chest pain and palpitations
- Abdominal pain,
nausea
- Diarrhea
- Sleep disturbance
- Poor concentration
and memory loss
- Irritability and
mood swings
- Depression
- Back pain
- Blurred vision and
eye pain
- Jaw pain
- Testicular/pelvic
pain
- Tinnitus
- Vertigo
- Cranial nerve disturbance
( facial numbness, pain, tingling, palsy or optic neuritis)
- Headaches
- Lightheadedness
- Dizziness
ILADS’ Lyme
Treatment Guidelines address 45 subjects:
- ILADS defined
- Chronic Lyme
disease: A growing epidemic
- The need for
new guidelines
- A problem of
definitions
- Competency and
training
- The increasing
role of primary care
- Highlights of
guidelines
- Symptomatic
presentations
- symptoms of
Lyme disease
- Increasing evidence
of persistent infection
- Disappointing
results of symptomatic treatment
- Severity of
chronic Lyme disease
- Atypical early
presentations
- New chronic
Lyme disease presentations
- The limitations
of physical findings
- Sensitivity
limitations of testing
- Seronegative
Lyme disease
- Continued importance
of differential diagnosis
- Clinical judgment
- Testing for
coinfection
- Prompt use of
antibiotics
- Choosing an
antibiotic
- Oral antibiotic
options
- Intravenous
antibiotic options
- Intramuscular
antibiotic options
- Combination
antibiotic treatment
- Sequential treatment
- Dosage
- Duration of
therapy
- Empiric treatment
- Persistent Lyme
disease
- Recurrent Lyme
disease
- Refractory Lyme
disease
- Treatment failure
- Symptomatic
treatment
- Fibromyalgia
- Decision to
stop antibiotics
- Alternative
antibiotics
- Therapy for
coinfection
- Ongoing development
of treatment guidelines
- Validation of
guidelines
- Comparative
studies
- Grading system
for evidence-based guidelines
- Comparison of
key IDSA and ILADS guidelines
- Criteria for
evidence-based guidelines
Adapted
from Cameron DJ, Gaito A, Harris N, Bach G, Bellovin S, Bock
K, Bock S, Burrascano J, Dickey C, Horowitz R, Phillips S, Meer-Sheerer
L, Raxlen B, Sherr V, Smith H, Smith P, Stricker R. Evidence-based
guidelines for the management of Lyme disease. Expert Rev. Anti-infect.
Ther. 2(1), 2004.
ILADS
thanks Turn the Corner Foundation and the LDA for their
non-profit financial support of the guidelines.
|
To purchase the guidelines, download the order form here. This requires Adobe Acrobat Reader, which may be obtained by clicking on the Get Acrobat Reader icon. |
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