Download An anti-trust investigation was initiated against the IDSA for its failure

Infectious Diseases Society of America’s Recommendations on the
Diagnosis and Treatment of Lyme Disease Unanimously Approved by an
Independent Review Panel
In November, 2006, an investigation was initiated to determine whether the
Infectious Diseases Society of America (IDSA) violated antitrust laws in promulgating
its 2006 guidelines on the diagnosis and treatment of Lyme disease (1). This
unprecedented legal action prompted an extensive review of the published IDSA
guidelines by an independent review panel. The review panel recently issued a final
report in which it unanimously approved all of the recommendations made in the
IDSA’s current guidelines (2).
The review panel, which relied on >1,000 published scientific papers in making its
deliberations, also affirmed that there is no published evidence to indicate that
extended antibiotic therapy is beneficial for the treatment of “chronic Lyme disease”.
It also affirmed that there is “no well-accepted definition of post-Lyme disease
syndrome”, and that there is “no convincing biologic evidence for the existence of
symptomatic chronic Borrelia burgdorferi infection among patients after receipt of
recommended treatment regimens for Lyme disease” (2).
It should be noted that the IDSA’s recommendations for the treatment of Lyme
disease are in agreement with those of the European Federation of Neurological
Societies (3), the European Union of Concerted Action on Lyme Borreliosis (4), the
American Academy of Neurology (5), the Canadian Public Health Network (6), and
the German Society for Hygiene and Microbiology (7). They also are in agreement
with recommendations made by expert panels from 10 European countries, namely,
The Czech Republic, Denmark, Finland, France, The Netherlands, Norway, Poland,
Slovenia, Sweden, and Switzerland. [An excellent summary of these expert panel
recommendations may be found in the presentation by O’Connell in the guidelines
section posted on this website]. None of these organizations or expert panels, as well
as the Centers for Disease Control (CDC) and the National Institutes of Health (NIH),
recommend extended antibiotic therapy for the treatment of “chronic Lyme disease”.
In contrast to much of the false and misleading information being propagated on the
internet and in the lay media, the IDSA guidelines (1), in addition to the websites
sponsored by the NIH (www.nih.gov) , the CDC (www.cdc.gov) , and the ALDF
(www.aldf.com) , are considered to be the best source of evidenced-based
information on Lyme disease for community physicians, medical practitioners, and
the general public.
References
1.
G. P. Wormser, R.J. Dattwyler, E.D. Shapiro, J.J. Halperin, A.C. Steere, M.S
Klempner, P.J. Krause, J.S. Bakken, F. Strle, G. Stanek, L. Bockenstedt, D.
Fish, J.S. Dumler, R.B. Nadelman, The clinical assessment, treatment, and
prevention of Lyme disease, human granulocytic anaplasmosis, and
babesiosis: clinical practice guidelines by the Infectious Diseases Society of
America. Clin. Infect. Dis., 43, 1089-1134, 2006.
2.
http://www.idsociety.org/Content.aspx?id=16499
3.
Mygland, U. Ljostad, V. Fingerle, T. Rupprecht, E. Schmutzhard, I. Steiner,
EFNS guidelines on the diagnosis and management of European Lyme
neuroborreliosis. Euro. J. Neurol. 17, 8-16, 2010.
4.
5.
http://meduni09.edis.at/eucalb/cms/index.php?lang=en
J.J. Halperin, E.D. Shapiro, E. Logigian, A.L. Belman, L. Dotevall, G.P.
Wormser, L. Krupp, G. Gronseth, C.T. Bever, Jr. Practice parameter:
treatment of nervous system Lyme disease (as evidence-based review).
Report of the Quality Standards Subcommittee of the American Academy of
Neurology. Neurol. 69, 91-102, 2007.
6.
Canadian Public Health Network, The laboratory diagnosis of Lyme
borreliosis: guidelines from the Canadian Public Health Laboratory Network,
Can. J. Infect. Dis. Med. Microbiol. 18, 145-148, 2007.
7.
R. Nau, H. Christen, H. Effert, Lyme disease- current state of knowledge,
Dtsch. Arztebl. Int. 106, 72-81, 2009.