Lyme Disease and Related Tick-Borne Infections - Highlights

Highlights

New Lyme Disease Guidelines

In 2006, the Infectious Diseases Society of America (IDSA) released updated guidelines on the prevention, clinical evaluation, and treatment of Lyme disease and related tick-borne infections. The IDSA’s last guidelines were released in 2000.

Preventive Antibiotics

The new guidelines recommend that under certain circumstances patients should receive a single dose of the antibiotic doxycycline within 72 hours of a tick bite to prevent the development of Lyme disease. Preventive antibiotics should only be given if a doctor can definitely identify the attached tick as an I. scapularis deer tick. If you have already removed the tick, be sure to tell your doctor if you develop a skin rash or flu-like symptoms within 30 days of the tick bite.

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Post-Lyme Disease Syndrome

One of the IDSA’s most important recommendations involves the definition and treatment of post-Lyme disease syndrome. According to the IDSA:

• Ninety-five percent of Lyme disease cases are cured with 10 – 28 days of antibiotic treatment. The IDSA emphatically recommends against longer-term antibiotic treatment due to the lack of any scientific evidence for its benefits. In addition, long-term antibiotics can increase the risk of drug resistance and Clostridium difficile bacterial disease.
• Lyme disease does not have a chronic state. Patients who have lingering non-specific symptoms 6 months after antibiotic treatment may not have had Lyme disease to begin with, or may have a new or different type of illness.

Alternative Remedy Warning

In 2006, the FDA warned against the use of bismacine (also called chromacine), an alternative medicine product. Bismacine is not approved for treatment of Lyme disease or any other illness. It contains a heavy metal that can be potentially fatal. The FDA is investigating one report of death and several reports of serious injury associated with bismacine use.

Review Date: 01/18/2007
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital