Access to Care in Lyme Disease: Clinician Barriers to Providing Care.

Patients with persistent Lyme disease/chronic Lyme disease (PLD/CLD) encounter significant barriers to accessing medical care. Although this health inequity has been explored from the patient perspective, the obstacles clinicians encounter when providing care to this group of patients have not been examined. The primary goal of this study was to identify the challenges faced by clinicians who provide care for patients with PLD/CLD.

Evidence-Based, Patient-Centered Treatment of Erythema Migrans in the United States.

Lyme disease, often characterized as a readily treatable infection, can be a debilitating and expensive illness, especially when patients remain symptomatic following therapy for early disease. Identifying and promoting highly effective therapeutic interventions for US patients with erythema migrans (EM) rashes that return them to their pre-infection health status should be a priority. The recently released treatment recommendations by the Infectious Diseases Society of America/American Academy of Neurology/American College of Rheumatology (IDSA/AAN/ACR) for the treatment of US patients fall short of that goal.

Chronic Lyme Disease: An Evidence-Based Definition by the ILADS Working Group.

: Chronic Lyme disease has been a poorly defined term and often dismissed as a fictitious entity. In this paper, the International Lyme and Associated Diseases Society (ILADS) provides its evidence-based definition of chronic Lyme disease. : ILADS defines chronic Lyme disease (CLD) as a multisystem illness with a wide range of symptoms and/or signs that are either continuously or intermittently present for a minimum of six months.

Controversies in Persistent (Chronic) Lyme Disease.

The Centers for Disease Control and Prevention estimates that more than 300 000 new cases of Lyme disease occur each year in the United States and that 10% to 20% of these patients will remain symptomatic despite receiving appropriate antibiotic therapy. Many elements of the disease are poorly understood and have generated considerable controversy. This paper discusses the medical controversies related to posttreatment manifestations and their potential impact on infusion nurses.

Antibiotic retreatment of Lyme disease in patients with persistent symptoms: a biostatistical review of randomized, placebo-controlled, clinical trials.

Introduction: Lyme disease (Lyme borreliosis) is caused by the tick-borne spirochete Borrelia burgdorferi. Long-term persistent illness following antibiotic treatment is not uncommon, particularly when treatment is delayed. Current treatment guidelines for persistent disease primarily rely on findings from four randomized, controlled trials (RCTs), strongly advising against retreatment.

The management of Ixodes scapularis bites in the upper Midwest.

Ixodes scapularis, commonly referred to as the deer tick, is the vector of Lyme disease and anaplasmosis; both illnesses are endemic to the upper Midwest. Avoidance of I scapularis bites is the primary preventative strategy for both infections. Antibiotic prophylaxis has been demonstrated to prevent Lyme disease, but similar studies have not investigated antibiotic prophylaxis for the prevention of anaplasmosis.