Re: IDSA Guidelines...can anyone tell me what this means?


McSweegan is a good guy wrote:

here's a question I have, and I apologize for not presenting the exact
quote. somewhere in the new IDSA guidelines, they discuss re-treatment
of late disease. and they state something like "re-treatment should
only be considered when objective clinical evidence of active disease
is obtained".

This?

"Late neurologic Lyme disease. Adult patients with late neurologic
disease affecting the central or peripheral nervous system should be
treated with intravenous ceftriaxone for 2 to 4 weeks (B-II).
Cefotaxime or penicillin G administered intravenously is an alternative
(B-II). Response to treatment is usually slow and may be incomplete.

Re-treatment is not recommended unless relapse is shown by reliable
objective measures.

Ceftriaxone is also recommended for children with late neurologic Lyme
disease (B-II). Cefotaxime or penicillin G administered intravenously
is an alternative (B-III). See the recommendations above on the
treatment of Lyme meningitis for suggested doses of each of these
antimicrobials".


"...however, the guidelines DON'T specifiy exactly what is
considered to be clinical evidence of continuing active disease. > > diagnosis is based upon clinical findings"

Yes. You wonder what "reliable objective measures" are...but maybe it's
best not to ask...if you think about it...ambiguity may equal
freedom...

Personally, I like the part about comparing the subjective complaints
of post-Lyme patients to similar aging boomers...or whatever...the
aches and pains of daily life...

But...guys...I have this guy I go to...called a "doctor"...and this
"doctor" is supposedly trained in the ability to distinguish between
the ordinary aches and pains of everyday life and what I do...and he
knows me...and he therefore has some insight into what type a patient I
am...how objective I am in reporting of my subjective symptoms...and he
sees what I do in his "office"...and he don't think it's the ordinary
aches and pains...and I was "appropriately treated" according to the
then existing guidelines...see, it isn't just me saying these things,
you see...

They conveniently fail to acknowledge that there are professional
witnesses to these "subjective complaints" in many cases...and are
simply trying to unload the persistence reports onto the backs of
whining patients.

Gotta love that...

.

Relevant Pages

  • Re: LDA v. IDSA Guidelines and CDC--"clinical discretion"
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  • Re: LDA v. IDSA Guidelines and CDC--"clinical discretion"
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  • Re: Biomarkers of REAL DISEASE
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