Guidelines Advising Against Retreating Persistent Lyme Disease Questioned
National guidelines that discourage additional therapy for persistent Lyme disease are called into question by an analysis of the research supporting the guidelines.
Writing in
Contemporary Clinical Trials, researchers find fault with four studies, all sponsored by the National Institutes of Health, that discourage further treatment with antibiotics for persistent symptoms of Lyme disease. Two of the four, according to the critique, did not include enough patients to detect a treatment effect; that is, they were underpowered. A third trial did find a treatment effect, but erroneously ascribed it to unmasking; and the fourth, according to the analysis, was "more reminiscent of a pilot study than a definitive clinical trial."
The authors conclude that until better studies are available, clinicians should "disregard generalized and unsupported recommendations against retreatment and instead rely on their clinical judgment to manage patients with persistent symptoms of Lyme disease."
Contemporary Clinical Trials article (Free abstract)
2006 IDSA guidelines on Lyme disease (Free)
Background: Physician's First Watch coverage of 2006 IDSA guidelines (Free)
