International Lyme And Associated Diseases Society
Leaders in Lyme Disease Education and Training
Donate to ILADS Now
Join ILADS Now

ILADS Lyme Disease Treatment Guidelines Summary

Download ILADS Lyme Guidelines
ILADS Publications
Articles and Presentations
ILADS Position Papers

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

Lyme Disease Symptoms:

  • 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:

  1. ILADS defined
  2. Chronic Lyme disease: A growing epidemic
  3. The need for new guidelines
  4. A problem of definitions
  5. Competency and training
  6. The increasing role of primary care
  7. Highlights of guidelines
  8. Symptomatic presentations
  9. symptoms of Lyme disease
  10. Increasing evidence of persistent infection
  11. Disappointing results of symptomatic treatment
  12. Severity of chronic Lyme disease
  13. Atypical early presentations
  14. New chronic Lyme disease presentations
  15. The limitations of physical findings
  16. Sensitivity limitations of testing
  17. Seronegative Lyme disease
  18. Continued importance of differential diagnosis
  19. Clinical judgment
  20. Testing for coinfection
  21. Prompt use of antibiotics
  22. Choosing an antibiotic
  23. Oral antibiotic options
  24. Intravenous antibiotic options
  25. Intramuscular antibiotic options
  26. Combination antibiotic treatment
  27. Sequential treatment
  28. Dosage
  29. Duration of therapy
  30. Empiric treatment
  31. Persistent Lyme disease
  32. Recurrent Lyme disease
  33. Refractory Lyme disease
  34. Treatment failure
  35. Symptomatic treatment
  36. Fibromyalgia
  37. Decision to stop antibiotics
  38. Alternative antibiotics
  39. Therapy for coinfection
  40. Ongoing development of treatment guidelines
  41. Validation of guidelines
  42. Comparative studies
  43. Grading system for evidence-based guidelines
  44. Comparison of key IDSA and ILADS guidelines
  45. 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 Lyme Disease Association for their financial support of the guideline development process.

Lyme disease symptoms»