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Prevention and Treatment of Lyme Disease

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

The prevention and treatment of Lyme disease varies depending on the clinical presentation. Antibiotic therapy remains the cornerstone of management; however, robust data demonstrating the most efficacious and cost-effective antibiotic, dose, route, and duration are limited.

Details about the commission and development of this guideline (Table)1 were discussed in the previous synopsis of this guideline.2

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Article Information

Corresponding Author: Adam S. Cifu, MD, University of Chicago, 5841 S Maryland Ave, MC 3051, Chicago, IL 60637 (adamcifu@uchicago.edu).

Conflict of Interest Disclosures: None reported.

References
1.
Lantos  PM , Rumbaugh  J , Bockenstedt  LK ,  et al.  2020 guidelines for the prevention, diagnosis and treatment of Lyme disease.   Clin Infect Dis. 2021;72(1):e1-e48. doi:10.1093/cid/ciaa1215PubMedGoogle ScholarCrossref
2.
Pitrak  D , Nguyen  CT , Cifu  AS .  Diagnosis of Lyme disease.   JAMA. Published February 15, 2022. doi:10.1001/jama.2022.0081Google Scholar
3.
Warshafsky  S , Lee  DH , Francois  LK ,  et al.  Efficacy of antibiotic prophylaxis for the prevention of Lyme disease.   J Antimicrob Chemother. 2010;65(6):1137-1144. doi:10.1093/jac/dkq097PubMedGoogle ScholarCrossref
4.
Wormser  GP , Ramanathan  R , Nowakowski  J ,  et al.  Duration of antibiotic therapy for early Lyme disease.   Ann Intern Med. 2003;138(9):697-704. doi:10.7326/0003-4819-138-9-200305060-00005PubMedGoogle ScholarCrossref
5.
Stupica  D , Lusa  L , Ruzić-Sabljić  E ,  et al.  Treatment of erythema migrans with doxycycline for 10 days versus 15 days.   Clin Infect Dis. 2012;55(3):343-350. doi:10.1093/cid/cis402PubMedGoogle ScholarCrossref
6.
Steere  AC , Levin  RE , Molloy  PJ ,  et al.  Treatment of Lyme arthritis.   Arthritis Rheum. 1994;37(6):878-888. doi:10.1002/art.1780370616PubMedGoogle ScholarCrossref
7.
Kortela  E , Kanerva  MJ , Puustinen  J ,  et al.  Oral doxycycline compared to intravenous ceftriaxone in the treatment of Lyme neuroborreliosis.   Clin Infect Dis. 2021;72(8):1323-1331. doi:10.1093/cid/ciaa217PubMedGoogle ScholarCrossref
8.
Klempner  MS , Hu  LT , Evans  J ,  et al.  Two controlled trials of antibiotic treatment in patients with persistent symptoms and a history of Lyme disease.   N Engl J Med. 2001;345(2):85-92. doi:10.1056/NEJM200107123450202PubMedGoogle ScholarCrossref
9.
Kaplan  RF , Trevino  RP , Johnson  GM ,  et al.  Cognitive function in post-treatment Lyme disease.   Neurology. 2003;60(12):1916-1922. doi:10.1212/01.WNL.0000068030.26992.25PubMedGoogle ScholarCrossref
10.
Cameron  DJ , Johnson  LB , Maloney  EL . Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease. International Lyme and Associated Diseases Society. Accessed February 2, 2022. https://www.ilads.org/patient-care/ilads-treatment-guidelines/
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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