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July 2009
Vol. 19 No. 7
Patient Care and Science
Review Panel Hears Range of Views on Lyme Disease

A special IDSA review panel held a hearing this month during which a wide range of perspectives on Lyme disease were aired, including views from prominent researchers, practicing physicians, and patients. IDSA established the review panel to examine whether the Society’s 2006 guidelines should be revised or updated.

A central question explored at the hearing was whether Lyme disease can persist as a chronic infection that can be successfully treated with an extended course of antibiotics.

The panel heard from some of the authors of IDSA’s guidelines, who concluded there is no convincing biologic evidence for symptomatic, chronic Borrelia burgdorferi infection after completion of the recommended treatment for Lyme disease, which, according to IDSA’s guidelines, is 10-28 days, depending on the stage of illness. Longer-term antibiotics may be dangerous and can lead to complications, according to IDSA.

But the panel also heard from several representatives of the International Lyme and Associated Diseases Society (ILADS), who argued for more extensive treatment for what ILADS identifies as chronic Lyme disease.

“In one sense, this panel’s job is standard practice, because all guidelines must be reviewed periodically to make sure they keep pace with science,” said Carol J. Baker, MD, FIDSA, chair of the review panel. “But this panel’s job is unique, because our focus goes beyond the usual approach to guidelines review by soliciting input from the general public, as well as the scientists who study Lyme disease and the physicians who treat it.”

Over the next several months, the panel will continue to review the medical and scientific literature as well as material submitted by the 18 individuals who testified at the July 30 hearing and about 150 other comments submitted by the public. The panel’s final report will recommend one of the following options: no change in the 2006 guidelines, sectional revision, or a complete rewrite. If the panel recommends a change or rewrite, then IDSA will convene a separate panel to carry out that task. 

IDSA is conducting the review as part of its voluntary agreement with the Attorney General of Connecticut, who had questioned the process used by IDSA’s 2006 guidelines panel but made no claims about the validity of IDSA’s medical recommendations. Members of the review panel were jointly selected through an open application process to ensure that the panel reflects a balanced variety of perspectives and experience.

“We hope to move forward as quickly as possible, while allowing adequate time to review all the medical evidence and other information submitted by the public,” Dr. Baker said. “We are all committed to seeing that people with Lyme disease get the best possible care and that the recommendations in IDSA’s guidelines are safe, effective, and based on sound medical evidence.”

The panel is expected to issue its final recommendation by the end of the year. Click here for an online archive of the hearing.
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