Clinicians Clash Over New Lyme Disease Guidelines

Mar. 23 -- FRIDAY, July 13 (HealthDay News) -- Lyme disease can be a confusing ailment, with symptoms differing between patients -- and sometimes even within the same patient -- as the infection runs its course.

That confusion now has spread to its treatment, with physicians locked in a fierce debate over how long the course of antibiotics needed to kill the infection should last.

The Infectious Disease Society of America (IDSA) came up with new guidelines in November, stating that "95 percent of cases of Lyme disease are cured with 10 to 28 days of oral antibiotics."

The guidelines also strongly object to the use of antibiotics in patients beyond 30 days, since long-term antibiotic treatment can cause drug resistance and create other medical risks.

But a substantial number of doctors and patients are arguing against the guidelines, saying that chronic cases of the infection require antibiotic treatment for much longer than one month.

About 20,000 Americans contract Lyme disease every year, said Dr. Gary Wormser, the infection disease specialist who chaired the panel that created the new guidelines.

Lyme disease has been reported in nearly all states, but more than 98 percent of all cases are found in coastal New England and the mid-Atlantic states, as well as Wisconsin, Minnesota and northern California.

The IDSA last updated its guidelines in 2001. The new guidelines represent the latest in scientific knowledge about Lyme disease, Wormser said.

"The available scientific evidence is compelling that there is no indication to treat patients with months-on-end of antibiotic therapy," said Wormser, who is chief of the division of infectious disease and vice chairman of the department of medicine at New York Medical College, in Valhalla, N.Y.

"Indeed, such prolonged antibiotic therapy is not only not beneficial but also places the patient at risk for serious adverse effects from the antibiotics, some of which can be life-threatening," Wormser added.