Lyme disease debate provokes treatment divide, legal action

In what may be a first, the government has taken steps to investigate the drafting of medical guidelines.

By Susan J. Landers, AMNews staff. Dec. 25, 2006.

Washington -- Dueling guidelines developed by two medical organizations for treating patients with Lyme disease have sparked such an uproar that Connecticut's attorney general has stepped in to see if one side ran afoul of antitrust statutes.

The Infectious Diseases Society of America and the International Lyme and Associated Diseases Society each assembled expert panels that sat down separately and examined the evidence on the nature of and best treatment for this tick-borne illness. But they arrived at different conclusions.

IDSA, a scientific organization of physicians, scientists and other health care professionals who specialize in infectious diseases, characterizes Lyme disease as primarily acute and treated successfully in the vast majority of cases with, at most, a few weeks of antibiotics. ILADS, which is a multidisciplinary medical society focused on the diagnosis and treatment of Lyme disease, holds out the possibility that the disease is chronic and may need months of antibiotics.

The differing conclusions call into question how best to treat the more than 20,000 people who contract the infection each year. Although Lyme disease has been reported in nearly all states, most cases are found in the Northeast, mid-Atlantic and North Central regions of the nation. Left untreated, the infection can spread to joints, the heart and the nervous system, according to the Centers for Disease Control and Prevention.

It is not unusual for different medical and scientific groups to take varying clinical positions on specific conditions. But this particular situation quickly has become far from typical.