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Posted Jul 15 2011 10:47am
At last a slight change in direction from the overly dependence on the IDSA Guidelines, well done to these doctors for producing these new Guidelines and referencing to more of the doctors who specialise in Chronic Lyme disease and have a better understanding than the narrow minded doctors who only see an acute form and thus they believe we can all be cured in just a couple of weeks antibiotics!

Most of the patients I am in touch with failed the IDSA's treatment of a couple of weeks antibiotics but have made significant progress on longer courses of treatment.

Deutsche Borreliose-Gesellschaft e. V.
Diagnosis and Treatment of Lyme borreliosis
Guidelines here

Just a few points mentioned
Chronic Lyme
Latency 8 years before symptoms developed.
50% not aware of tick bite
50% no EM
Seronegativity following early anti-biotic treatment therefore does not rule out Lyme borreliosis in any way.
Chronic stage
Lyme borreliosis can lead to numerous symptoms. The following are particularly frequent:
• fatigue (exhaustion, a chronic feeling of illness)
• encephalopathy (impaired cerebral function)
• muscular and skeletal symptoms
• neurological symptoms (including polyneuropathy)
• gastrointestinal symptoms
• urogenital symptoms
• ocular symptoms
• cutaneous symptoms
• heart diseases.
The success of treatment must be assessed clinically
A negative serological finding does not rule out Lyme borreliosis
There may be a disease requiring treatment even without the detection of antibodies. (Causes: e. g. antibi-otic treatment starting early but inadequate with immunodepressants, including cortisone, exhaustion of the immune system, masking of the causative agents, genetic disposition.)
Co-infections can be transmitted by ticks or by other routes of infection
The scientific basis for antibiotic treatment is still inadequate at the present time, with the exception of the localised early stages (EM). The considerable shortcomings in the scientific-clinical analysis are reflected in therapeutic guidelines, which are severely limited in the reli-ability of their recommendations and in their evidence base in the international litera-ture,(159) and they do not meet the requirements from the medical and health-policy aspects.

Successful antibiotic treatment is possible only if the individual has an effective immune sys-tem. With regard to antibiotic treatment, problems also arise with Borrelia due to natural or acquired resistance. The causative agent of Lyme borreliosis can evade the immune system by what are known as “escape mechanisms”
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