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New Draft Lyme Disease Guidelines released by IDSA/AAN/ACR

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The Infectious Diseases Society of America, American Academy of Neurology, and American Academy of Rheumatology have issued new draft guidelines on Lyme disease. The guidelines were last updated in 2006. The draft of the guideline is open for a comment period of 45 days on the document with a submission deadline of Aug 10 2019.f

The major  recommendations are:

  • Prophylactic antibiotics (a single dose of oral doxycycline) should be administered to patients within 72 hours of removing a tick after a high-risk bite, but not after lower-risk bites. High-risk bites must meet all of the following criteria: from an Ixodes tick, in a highly endemic area, and from a tick engorged and attached for 36 hours or more.
  • For erythema migrans, preferred treatments include 10 days of doxycycline or 14 days of amoxicillin, cefuroxime axetil, or phenoxymethylpenicillin.
  • For patients presenting with meningitis, painful radiculoneuritis, mononeuropathy multiplex, or acute cranial neuropathies, along with plausible exposure to high-risk ticks, Lyme testing is recommended. Routine testing is not recommended for patients with other neurological syndromes or psychiatric illnesses.
  • The groups suggest against routine testing in children presenting with developmental, behavioral, or psychiatric disorders.
  • Additional antibiotics are not recommended in patients with persistent or recurring nonspecific symptoms (e.g., pain, fatigue) after treatment for Lyme disease but who don’t have evidence of reinfection or treatment failure.
  • For patients who have persistent or recurring non-specific symptoms such as fatigue, pain, or cognitive impairment following Lyme treatment, the guidelines advise against additional antibiotics. The authors also call for more studies on patients who’ve been diagnosed as having chronic Lyme disease—a term that currently lacks an accepted definition but refers to patients with infections lasting more than 6 months.

The experts feel that these guidelines are a welcome update to the previous version, which is now more than a decade old as they are comprehensive and evidenced-based.

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For further reference log on to:

https://www.idsociety.org/practice-guideline/Lyme-Disease-Guideline-Public-Comments/

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  1. user
    Andras LAKOS MD DSc, August 4, 2019, 11:13 pm

    I have looked through the „Draft” and found an important question concerning the dosage of antibiotics. For example, if you follow the instructions, a child weighing 30 kg should be treated by the same dose of amoxicillin as a patient of 120 kg. I think that in a seriously obese population as you have in the US the guideline should suggest dosage for people with overweight, too. I would advise to rethink that a child of 30 kg will receive the same amount of amoxicillin as a patient with 60 kg following the new guideline.
    Ctr for Tick-borne Dis., Budapest

  2. user
    Ashleigh Smith June 29, 2019, 11:19 pm

    No improvement, very dismissive guidelines, people will continue to get misdiagnosed and hence suffer from persistent infection, for which there is currently no cure. Advice for the IDSA: follow the latest research coming out of Johns Hopkins Bloomberg School of Public Health and consider adding a degree of integrity to your guidelines and compromising a bit of your special interests. You\’re doing an unimaginable amount of harm to the public and with these guidelines will continue to be responsible for unnecessary and endless suffering and deaths. Sorry, but we\’re going to become more powerful than you soon, and more influential over the US Government. You are responsible for the humanitarian crisis. It\’s to your own detriment and decline.

  3. Shame on the IDSA as these diseases are truly afflicting so many in the population. Sadly in the 13 years since they last published something nothing has changed in my mind from what they stated before. For one, We have the state of PA now testing for various tick born illnesses in the state thru East Stroudsburg University- the new guidelines don\’t even touch upon the various diseases a tick can cause and how doxycycline doesn\’t even touch some of those other diseases. They dont\’ even mention Bartonella, Babeisa and Mycoplasma and most Lyme patients dont\’ have just Lyme! To me these guidelines can be legally challenged and any doc who uses them can seriously be at fault. As a nation we have to truly get on top of this. If a doc misses a call on Lyme and it gets into the later stages – the doc and the guidelines he followed have to be seriously takenup with legal action. No longer can we stand for this. There is plenty of scientific evidence out there showing the spirochete thrives and lives on – in my family of 5 along I can show you tests and evidence that it continues along. The IDSA has done nothing to help the Lyme community it is now time we turn against them.

  4. Baloney! And the Mentally Ill have no Right to Treatment of this PHYSICAL EVIL MANIFESTATION…WHAT?

  5. user
    Debbie Shrewsbury June 29, 2019, 8:06 am

    This is just further proof they have no idea what they are treating and do not understand tick born illness at all. My daughter had what I now know was a bulls eye from a tick that we never saw. I had no idea what it was and treated as a spider bite. Going to a doctor in Arkansas would have been useless since most don’t believe it exists in Arkansas. There has to be more education, better tests, freedom to treat symptoms whether they fit in their rigid guidelines or not.

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