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<sup>1</sup> <b>CDC 2021.</b> Lyme Disease: Neurologic Lyme Disease. Last reviewed 8/11/21. <a href=https://www.cdc.gov/lyme/treatment/NeurologicLyme.html><u>Accessed 6/20/23</u></a>
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<sup>2</sup> <b>NICE 2018.</b> Lyme Disease - NICE Guideline (NG95). National Institute for Health and Care Excellence. Published 4/11/18. Last updated 10/17/18. <a href=https://www.nice.org.uk/guidance/NG95><u>Accessed 5/31/23</u></a>
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<sup>3</sup> <b>IDSA/AAN/ACR 2020.</b> Lantos PM, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. <i>Clin Infect Dis.</i> 2021. Jan 23;72(1):1-8. <a href=https://www.idsociety.org/practice-guideline/lyme-disease/><u>Accessed 5/31/23</u></a>
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<sup>*</sup> <b>ILADS 2021. </b> ILADS diverges from CDC, IDSA, and NICE, recommending extended tx of at least 4-6wk w/ doxycycline, amoxicillin, or cefuroxime axetil for EM, and stating that pts w/ disseminated dz may need even longer courses & possibly combinations of multiple abx.
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Lyme Disease Basics for Providers: A Brief Primer by International Lyme and Associated Diseases Society. <a href=https://www.ilads.org/research-literature/lyme-disease-basics-for-providers/><u>Accessed 5/31/23</u></a>
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<b>Numerous groups, incl the Infectious Diseases Society of America (IDSA), have raised concern about the quality, validity, and inherent bias of International Lyme and Associated Diseases Society (ILADS) guidance, which does not meet epocrates editorial standards. We include their recommendations here not as an endorsement of their validity but to provide context when confronted w/ pt questions arising from ILADS recommendations.</b>
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<sup>2</sup> <b>NICE 2018.</b> Lyme Disease - NICE Guideline (NG95). National Institute for Health and Care Excellence. Published 4/11/18. Last updated 10/17/18. <a href=https://www.nice.org.uk/guidance/NG95><u>Accessed 5/31/23</u></a>
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<sup>3</sup> <b>IDSA/AAN/ACR 2020.</b> Lantos PM, et al. Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease. <i>Clin Infect Dis.</i> 2021. Jan 23;72(1):1-8. <a href=https://www.idsociety.org/practice-guideline/lyme-disease/><u>Accessed 5/31/23</u></a>
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<sup>*</sup> <b>ILADS 2021. </b> ILADS diverges from CDC, IDSA, and NICE, recommending extended tx of at least 4-6wk w/ doxycycline, amoxicillin, or cefuroxime axetil for EM, and stating that pts w/ disseminated dz may need even longer courses & possibly combinations of multiple abx.
<br><br>
Lyme Disease Basics for Providers: A Brief Primer by International Lyme and Associated Diseases Society. <a href=https://www.ilads.org/research-literature/lyme-disease-basics-for-providers/><u>Accessed 5/31/23</u></a>
<br><br>
<b>Numerous groups, incl the Infectious Diseases Society of America (IDSA), have raised concern about the quality, validity, and inherent bias of International Lyme and Associated Diseases Society (ILADS) guidance, which does not meet epocrates editorial standards. We include their recommendations here not as an endorsement of their validity but to provide context when confronted w/ pt questions arising from ILADS recommendations.</b>
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Treat for acrodermatitis chronica atrophicans (ACA) in late disseminated dz; lesions treated early may fully resolve; however, pts w/ later-stage ACA may have permanent skin damage even after tx<sup>3</sup>