The International Lyme and Associated Diseases Society (ILADS) have produced new evidence-based guidelines for the management of patients with Lyme disease. The guidelines address three clinical questions;
- The usefulness of antibiotic prophylaxis for known tick bites
- The effectiveness of erythema migrans treatment
- The role of antibiotic retreatment in patients with persistent manifestations of Lyme disease.
Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004. These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system.
Full new ILADS guidelines can be read here;
http://informahealthcare.com/doi/abs/10.1586/14787210.2014.940900
Original ILADS guidelines can be found here;
http://www.ilads.org/lyme/treatment-guideline.php
Infectious disease consultants and other NHS practitioners use guidelines based on the Infectious Disease society of America (IDSA) and the British Infection Association.
The current UK guidelines that should be used within the NHS are these:
https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/399239/Lyme_disease_referral_pathway_Jan_2015.pdf
This document is very useful to show to GPs and consultants if you think they aren’t following the correct pathway.
There are many uncertainties surrounding the diagnosis and treatment of Lyme disease, as documented by the James Lind Alliance.