The treatment of Lyme disease using the IDSA and ILADS methods still raises a lot of controversy. IDSA - the American Society for Infectious Diseases - has developed a standard treatment for Lyme disease that is questioned by ILADS, the International Society for Lyme Disease and Related Diseases. Check out what both methods of Lyme disease treatment are all about.

Treatment of Lyme diseaseis possible with two methods. The standard method of treatment recommended by the Polish Society of Epidemiologists and Doctors of Infectious Diseases and which is widely used by most Polish doctors, was developed by the American Society of Infectious Diseases ( IDSA- The Infections Diseases Society of America).

A completely different therapy is proposed by the International Lyme and Associated Diseases Society ( ILADS- The International Lyme and Associated Diseases Society).

Check:

  • Lyme disease treatment - IDSA method
  • Lyme disease treatment - ILADS method

Lyme disease treatment - IDSA method

Experts at the IDSA recommend that you administer the antibiotic only when the first symptoms of Lyme disease appear.

Routine medication is not required when bitten by ticks. They can only be used in specific cases:

  • the tick belonged to the speciesI. scapularisand stay in the skin for at least 36 hours
  • less than 72 hours have passed since the tick was removed
  • in a given territory min. 20 percent ticks are infected withB. Burgdorferi
  • treatment is not contraindicated

The patient can then be given a single dose of doxycycline(200 mg for an adult) to prevent Lyme disease.

IDSA, unlike ILADS, does not recommend long-term therapy, combination therapy, and specific dietary supplementation

In case of Lyme disease symptoms, the patient is given only one antibiotic (in standard, small doses) for a short time, only for 3-4 weeks. The doctor can choose from doxycycline, amoxicillin and cefuroxime.

In certain cases (e.g. in the course of LNB), antibiotics can be administered intravenously. Then you can use drugs such as ceftriaxone, cefotaxime and penicillin G.Choice of drug, routeadministration and the exact duration of therapy depend on the form of the disease and the patient's tolerance.

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After about a month of antibiotic treatment, the patient is considered cured, and any symptoms that do not disappear are treated as post-relapse syndrome.

The therapy can be repeated, but only in the case of late Lyme disease with joint symptoms or Lyme disease with proven spirochete.

If, despite treatment, arthritis persists and the PCR result from the synovial fluid is negative, symptomatic treatment is applied, including non-steroidal anti-inflammatory drugs.

Howeverthe therapy proposed by IDSA gives the best results up to three weeks after infection.The older Lyme disease is, the less effective the treatment is, and the symptoms may come back and worsen after treatment.

What should you know about Lyme disease?

Lyme disease treatment - ILADS method

ILADS specialists do not wait until the first symptoms of the disease appear. Due to the possible he alth effects of chronic Lyme disease, in their opinion, it is advisable to start treatment when the disease is highly probable.

According to one of the authors of the guidelines for the treatment of Lyme disease using the ILADS method, the probability of infection is high if:

In the ILADS method, antibiotic therapy should be supplemented with an appropriate diet and a set of probiotics, vitamins and trace elements

  • the tick came from endemic areas
  • stayed in the body for several hours
  • was filled with blood
  • not completely removed

In such situations, the patient should take oral antibiotics for 28 days.In their opinion, it is better to risk antibiotic therapy than to allow Lyme disease to develop further.

However, in the case of diagnosing Lyme disease, experts from ILADS recommend using quite aggressive therapy.

The treatment they proposed is based on taking a mixture of several antibiotics in very large doses for a long perioduntil the symptoms of Lyme disease disappear.

Then, after the symptoms have resolved, the patient must take antibiotics for another 2 to 4 months to eliminate the spores of the bacteria.

Only after this time the doctors consider the patient cured. Therefore, in some casestreatment may last for several years in total.

This is for the benefit of the patient, because - as ILADS experts argue - improperly treated Lyme disease has a tendency to recur, turning into a chronic phaseand becomes resistant to treatment.

They assume that the infected body is home to various forms of bacteria, including cysts. Cysts allow bacteria to survive in the antibiotic solution and are responsible for relapses when treatment is stopped (similar to tuberculosis and leprosy).

Usually the patient is given antibiotics orally. Among them are drugs such as: amoxicillin, azithromycin, cefuroxime, clarithromycin, doxycycline and tetracycline. Their doses should be higher than the standard (300-400 mg).

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Indications for intravenous antibiotic therapy are chronic, recurrent and refractory Lyme disease, as well as Lyme meningitis and Lyme arthritis.

Read:Complications after Lyme disease - neurological, joint, cardiac

Then drugs such as ceftriaxone, cefotaxime or penicillin are administered, and recently other antibiotics have joined this group - imipenem, azithromycin and doxycycline.

As a last resort, only in the case of multiple relapses after oral and intravenous therapy, an antibiotic (benzylpenicillin) is administered intramuscularly.

Bibliography:

Sokalska-Jurkiewicz M., Lyme disease, "Służba Zdrowia" 2007, No. 80-83

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Research