Friday, March 27, 2009

Does chronic Lyme disease exist?

This controversy continues to heat up. The “mainstream” view, as promulgated in the 2006 IDSA guidelines, is that it is essentially nonexistent. The “alternative view”, supported by the ILADS, advocates for recognition of chronic Lyme disease and supports long term antibiotic treatment.

The ILADS position is problematic because it allows for antimicrobial treatment absent laboratory confirmation and based on vague symptoms. On the other hand the IDSA was investigated by the Connecticut Attorney General's Office which found conflicts of interest and other problems in the IDSA guideline development process. At the recommendation of the Attorney General the IDSA has agreed to a review of the 2006 guidelines by a disinterested panel, with the potential for revision or replacement of the guidelines. That review is a work in progress, with recent updates here and here.

Recent journal articles representing the competing views can be found here and here.

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