New guidelines for the prevention, diagnosis, and treatment of Lyme disease have been developed through a collaboration between the Infectious Diseases Society of America, the American Academy of Neurology, and the American College of Rheumatology.
The guidelines offer recommendations for clinicians treating patients with Lyme disease. The recommendations address clinical questions related to the prevention, diagnosis, and treatment of Lyme disease; complications from neurologic, cardiac, and rheumatic symptoms; disease expression commonly seen in Eurasia; and complications from coinfection with other tick-borne pathogens.
Specifically, there are 43 recommendations related to diagnostic testing, including testing scenarios, detailed recommendations about Lyme carditis, and a discussion of “chronic Lyme disease.” The guidelines recommend clinical diagnosis without laboratory testing for people with a skin rash characteristic of early Lyme disease. The guidelines recommend antibody testing for people with other signs of Lyme disease, such as swollen joints or meningitis.
Among the treatment recommendations, the guidelines call for oral antibiotic therapy for most patients with Lyme disease. The therapy duration is 10 to 14 days for early Lyme disease, 14 days for Lyme carditis, 14 to 21 days for neurologic Lyme disease, and 28 days for late Lyme arthritis.
The guidelines were developed by a panel of 36 experts from the three organizations, three patient representatives, and one health care consumer representative. Each of the three sponsoring organizations elected a co-chair to lead the panel, while a fourth co-chair was selected for their expertise in guideline methodology.
Roughly 30,000 Lyme disease cases are reported annually, but the Centers for Disease Control and Prevention estimates there are more than 300,000 cases in the United States each year.