REVIEW PAPER
Controversies related to diagnosis and treatment of Lyme borreliosis worldwide
1
Katedra Chirurgii i Pielęgniarstwa Chirurgicznego, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny, Lublin
2
Pracownia Pielęgniarstwa Środowiskowego, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny, Lublin
Corresponding author
Edyta Gałęziowska
Pracownia Pielęgniarstwa Środowiskowego, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie, ul. Staszica 6 (Collegium Maximum), 20–081 Lublin
Pracownia Pielęgniarstwa Środowiskowego, Wydział Nauk o Zdrowiu, Uniwersytet Medyczny w Lublinie, ul. Staszica 6 (Collegium Maximum), 20–081 Lublin
Med Og Nauk Zdr. 2015;21(4):372-377
KEYWORDS
ABSTRACT
Introduction:
Lyme disease is the most frequent ticks-borne disease worldwide, and one of the most controversial diseases in the history of medicine. It is caused by spirochaete Borrelia burgdorferi, a multi-organ and chronic disease with a multiphase course.
Objective:
The aim of the study is presentation of opposite views of two American scientific societies, IDSA (Infectious Diseases Society of America) and ILADS (International Lyme And Associated Diseases Society), regarding the criteria of diagnosing and methods of treating Lyme borreliosis, and attracting attention to the legal problems of one of these societies.
State of knowledge:
The IDSA has a significant impact on the healthcare available for people suffering from Lyme borreliosis, both in the United States and in Europe. This medical society is very influential and its guidelines constitute a basis for similar recommendations concerning diagnosis and treatment of borreliosis in Europe, including Poland. Another group of physicians, the ILADS, has an opposite view. This article shows the debate between these two groups. According to Stricker RB, Lautin A and Burrascano JJ, one of the most important factors leading to the treatment-related controversy is the lack of reliable tests that could be used in monitoring the treatment and determining the moment of recovery or presence of co-infection which could complicate the course of the disease. It should be noted that the domination of the IDSA views and their significant effect on healthcare lead to the situation in which the IDSA guidelines concerning the diagnosis and treatment of Lyme borreliosis can hinder the possibilities of treating patients.
Summary:
Medical societies are under obligation to confirm justified controversies in the treatment methods, especially if the debate concerns the lack of sufficient evidence. This means that different points of view should be represented in guidelines-creating panels, and that justified controversies should be acknowledged and included in the text of those guidelines.
Lyme disease is the most frequent ticks-borne disease worldwide, and one of the most controversial diseases in the history of medicine. It is caused by spirochaete Borrelia burgdorferi, a multi-organ and chronic disease with a multiphase course.
Objective:
The aim of the study is presentation of opposite views of two American scientific societies, IDSA (Infectious Diseases Society of America) and ILADS (International Lyme And Associated Diseases Society), regarding the criteria of diagnosing and methods of treating Lyme borreliosis, and attracting attention to the legal problems of one of these societies.
State of knowledge:
The IDSA has a significant impact on the healthcare available for people suffering from Lyme borreliosis, both in the United States and in Europe. This medical society is very influential and its guidelines constitute a basis for similar recommendations concerning diagnosis and treatment of borreliosis in Europe, including Poland. Another group of physicians, the ILADS, has an opposite view. This article shows the debate between these two groups. According to Stricker RB, Lautin A and Burrascano JJ, one of the most important factors leading to the treatment-related controversy is the lack of reliable tests that could be used in monitoring the treatment and determining the moment of recovery or presence of co-infection which could complicate the course of the disease. It should be noted that the domination of the IDSA views and their significant effect on healthcare lead to the situation in which the IDSA guidelines concerning the diagnosis and treatment of Lyme borreliosis can hinder the possibilities of treating patients.
Summary:
Medical societies are under obligation to confirm justified controversies in the treatment methods, especially if the debate concerns the lack of sufficient evidence. This means that different points of view should be represented in guidelines-creating panels, and that justified controversies should be acknowledged and included in the text of those guidelines.
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