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Physician preferences in the diagnosis and treatment of Lyme disease in the United States

Bevorzugte Methoden in der Diagnostik und Therapie der Lyme-Borreliose bei amerikanischen Ärzten

  • Special Addendum — Part II
  • Therapy And Prophylaxis In Lyme Borreliosis
  • Published:
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Summary

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.

Zusammenfassung

Zur Erhebung von Daten zur Präferenz amerikanischer Ärzte in der Diagnostik und Therapie der Lyme-Borreliose wurden in verschiedenen endemischen Gebieten der USA Fragebogen an Ärzte verschickt. 78 Antworten wurden ausgewertet. 86% der Befragten forderten eine Untersuchung mittels ELISA und Western Blot. 50% der Befragten gaben an, daß ihrer Ansicht nach 25% der Patienten mit Lyme-Borreliose seronegativ sind. In der Therapiewahl ist ein Einfluß der Spezialisierung der Ärzte zu erkennen. 20% der Befragten verordnen nach Zeckenstich ein Antibiotikum. Alle Ärzte gaben an, das Erythema migrans auch ohne serologische Bestätigung mit Antibiotika zu behandeln. Die mediane Behandlungsdauer bei Erythema migrans betrug 4 Wochen. Eine nach Erythema migrans auftretende Lyme Borreliose wurde von 43% der Befragten 3 Monate oder länger behandelt. Die von uns durchgeführte Umfrage deckte erhebliche Unterschiede zwischen publizierten Empfehlungen und der Praxis auf. Es ist erforderlich, die Gründe für diese Unterschiede aufzuklären und den Ärzten Fortbildung anzubieten.

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Authors and Affiliations

  1. Lyme Disease Foundation, 1 Financial Plaza, 06103-2610, Hartford, Connecticut

    Martina H. Ziska M. D.

  2. Boston University and Boston VA Medical Centers, 88 E. Newton, 02118, Boston, Massachusetts

    S. T. Donta M. D.

  3. Zygo Corporation, Laurel Brook Rd., 06455, Middlefield, Connecticut, USA

    F. C. Demarest

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  1. Martina H. Ziska M. D.
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  2. S. T. Donta M. D.
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  3. F. C. Demarest
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Ziska, M.H., Donta, S.T. & Demarest, F.C. Physician preferences in the diagnosis and treatment of Lyme disease in the United States. Infection 24, 182–186 (1996). https://doi.org/10.1007/BF01713336

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