Lyme Treatment Guidelines Development Page 2

Lyme Disease Practice

Lyme Disease Treatment
Guideline Development- Page 2

Topics In Guidelines

ILADS' Lyme Treatment Guidelines address 45 subjects:

ILADS defined
Chronic Lyme disease: A growing epidemic
The need for new guidelines
A problem of definitions
Competency and training
The increasing role of primary care
Highlights of guidelines
Symptomatic presentations
Symptoms of Lyme disease
Increasing evidence of persistent infection
Disappointing results of symptomatic treatment
Severity of chronic Lyme disease
Atypical early presentations
New chronic Lyme disease presentations
The limitations of physical findings
Sensitivity limitations of testing
Seronegative Lyme disease
Continued importance of differential diagnosis
Clinical judgment
Testing for coinfection
Prompt use of antibiotics
Choosing an antibiotic

Oral antibiotic options
Intravenous antibiotic options
Intramuscular antibiotic options
Combination antibiotic treatment
Sequential treatment
Dosage
Duration of therapy
Empiric treatment
Persistent Lyme disease
Recurrent Lyme disease
Refractory Lyme disease
Treatment failure
Symptomatic treatment
Fibromyalgia
Decision to stop antibiotics
Alternative antibiotics
Therapy for coinfection
Ongoing development of treatment guidelines
Validation of guidelines
Comparative studies
Grading system for evidence-based guidelines
Comparison of key IDSA and ILADS guidelines
Criteria for evidence-based guidelines.

Adapted from Cameron DJ, Gaito A, Harris N, Bach G, Bellovin S, 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.

To order a copy of these guidelines visit the www.ILADS.org.

Timetable For Development Guidelines


2001	Practice treatment Guideline proposed by the International Lyme and Associated Diseases Society (ILADS).
2001	The experts from the ILADS board proposed to prepare guidelines consisting of experts in primary care, rheumatology, immunology, hematology, preventive medicine, preventive medicine, and psychiatry.
2002	MEDLINE, other databases, references of articles, and the collective experience of board members in treating thousands of Lyme disease patients were reviewed.
2002	The board reviews drafts of the guidelines.
2003	The board adopts the final draft of the guidelines.
2003	The guidelines are sent out for external peer review.
2004	The guidelines are in press in the Expert Review of Anti-infective Therapy. Ther. 2(1), Suppl. (2004) Future Drugs Ltd.
2004	The guidelines were disseminated through ILADS. The first printing was sold out. The second printing is made available.
2004	The guidelines are adopted by CALDA and Lyme Disease Association (national).
2004	The guidelines are published in the summer 2004 issue of LymeTimes.
2004	The guidelines were validated with a POEM - timely treatment - Patient Oriented Medicine that Matters.
2004	The guidelines are expected to appear in the National Guideline Clearinghouse by the end of October 2004.
Future	The guidelines will be reviewed and recommendations update accordingly.