I know it is well-known by people on this forum that the IDSA's guidelines for the treatment of Lyme disease are in no way reflective of reality and lead to unnecessary pain and suffering for thousands of people. But I didn't realize some important ways in which the IDSA guidelines differ from those of other countries, and those for other diseases.
Out of curiosity, I looked up the UK's mainstream Lyme treatment guidelines (https://www.nice.org.uk/guidance/ng95/chapter/Recommendations#management) and noticed some subtle, but important differences:
- Nowhere is a course of antibiotics shorter than 21 days recommended (except for azithromycin, which lasts much longer in the bloodstream, at 17 days)
- Dosage recommendations for amoxicillin are higher
- In the case of persisting symptoms, physicians are directed to consider the possibility of treatment failure and treat with a second course of antibiotics using a different front-line agent
- It does not encourage further antibiotic treatment by GP's after two courses, but says "referral to a specialist" may be required
And then, looking at the CDC guidelines for treating syphilis (https://www.cdc.gov/std/tg2015/syphilis.htm), you see that doctors are supposed to follow up with patients extensively and evaluate for signs of treatment failure, retreating as necessary.
In both cases, the guidelines use neutral-sounding language and acknowledge that the standard treatments are not infallible. This makes the snide language in the IDSA guidelines about
"chronic" disease seem even stranger, and the absolute certainty the IDSA appears to have about
the eradication of Lyme with a single course of antibiotics, and the "do nothing" approach to continued symptoms seem even more out of line.
I'm not sure what's going on at the IDSA, but their guidelines seem out of step with science, common sense, and any reasonable standard for patient care.
Post Edited (1yrinVA) : 8/25/2018 3:24:52 PM (GMT-6)