Treatment for Lyme disease
Anyone who has been bitten by a tick should be watched closely for at least 30 days.
A single dose of antibiotics may be offered to someone soon after being bitten by a tick, if all of the following are true:
- The person has a tick attached to their body that can carry Lyme disease (this usually means that a nurse or physician has identified the tick)
- The tick is thought to have been attached to the person for at least 36 hours
- The person is over 8 years old and is not pregnant or breastfeeding
A 2 – 4-week course of antibiotics is used to treat people who are diagnosed with Lyme disease. The specific antibiotic used depends on the stage of the disease and the symptoms. Standard treatment (30 days on antibiotics) may not be enough and that patients may develop chronic Lyme disease if the primary treatment does not work. They go on to advocate that 1-4 years of antibiotic treatment may be better to completely eradicate the bacteria. Pain medications, such as ibuprofen, are sometimes prescribed to relieve joint stiffness.
Early Lyme
Doctors are likely to recommend more aggressive and longer antibiotic treatment for patients. They may, for instance, treat “high risk” tick bites where the tick came from an endemic area, was attached a long time, and was removed improperly. They may treat a Lyme rash for a longer period of time than the IDSA recommends to ensure that the disease does not progress. They are unlikely to withhold treatment pending laboratory test results.
Late Lyme
Experts agree that the earlier you are treated, the better; and early treatment is often successful. Unfortunately, more than half of the patients treated with short-term antibiotics continue to have significant symptoms. The quality of life of patients with chronic Lyme disease is similar to that of patients with congestive heart failure. Doctors don’t agree about the cause of these ongoing symptoms. The primary cause of this debate is the lack of a diagnostic test that can determine whether the disease has been eliminated from the body in patients who have persistent symptoms.
The IDSA (Infectious Diseases Society of America) thinks Lyme symptoms after treatment represent a possible autoimmune, “post-Lyme syndrome” that is not responsive to antibiotics. ILADS physicians believe that on-going symptoms probably reflect active infection, which should be treated until the symptoms have resolved. These physicians are using the types of treatment approaches for persistent infections like tuberculosis, including combination treatment with more than one antibiotic and longer treatment duration.
Information Courtesy of Lyme Disease.org
Evidence-based guidelines for the management of patients with Lyme disease, human granulocytic anaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis were prepared by an expert panel of the Infectious Diseases Society of America. These updated guidelines replace the previous treatment guidelines published in 2000 (Clin Infect Dis 2000; 31[Suppl 1]:1–14). The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. For each of these Ixodes tickborne infections, information is provided about prevention, epidemiology, clinical manifestations, diagnosis, and treatment. Tables list the doses and durations of antimicrobial therapy recommended for treatment and prevention of Lyme disease and provide a partial list of therapies to be avoided. A definition of post–Lyme disease syndrome is proposed.
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