Physician preferences in the diagnosis and treatment of Lyme disease in the United States.
To assess physician preferences in the diagnosis and treatment of Lyme disease, questionnaires were sent to physicians in various Lyme disease endemic areas in the U.S. Seventy-eight responses were analyzed. Both ELISA and Western blot were ordered by 86% of responders. Fifty percent of responders believed that 25% or more of patients who have Lyme disease were seronegative. The treatment was influenced by physician specialty. Antibiotic treatment for tick bite was prescribed by 20% of responders. Erythema migrans rash was treated by all responders without serologic confirmation. The median treatment duration of erythema migrans was 4 weeks. For post-erythema migrans Lyme disease, 43% of responders treat 3 months or more; for chronic Lyme disease, 57% of responders treat 3 months or more. Our survey documents significant differences between published recommendations and actual practices. Physician education and clinical trials are needed to clarify the reasons for these differences.
Ziska
M H
MH
Lyme Disease Foundation, Hartford, Connecticut 06103-2610, USA.
Donta
S T
ST
Demarest
F C
FC
D000658:Amoxicillin / Q000627:therapeutic use; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001733:Bites and Stings / Q000188:drug therapy*; D015153:Blotting, Western / Q000706:statistics & numerical data; D004318:Doxycycline / Q000627:therapeutic use; D004797:Enzyme-Linked Immunosorbent Assay; D015787:Erythema Chronicum Migrans / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008193:Lyme Disease / Q000175:diagnosis* / Q000188:drug therapy*; D010406:Penicillins / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012698:Serologic Tests; D011795:Surveys and Questionnaires; D013754:Tetracyclines / Q000627:therapeutic use; D013987:Ticks / Q000382:microbiology; D014481:United States
D000900:Anti-Bacterial Agents; D010406:Penicillins; D013754:Tetracyclines; D000658:Amoxicillin; D004318:Doxycycline