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Unformatted text preview: IDSA Guidelines CID 2006:43 (1 November) 1089 I D S A G U I D E L I N E S The Clinical Assessment, Treatment, and Prevention of Lyme Disease, Human Granulocytic Anaplasmosis, and Babesiosis: Clinical Practice Guidelines by the Infectious Diseases Society of America Gary P. Wormser, 1 Raymond J. Dattwyler, 2 Eugene D. Shapiro, 5,6 John J. Halperin, 3,4 Allen C. Steere, 9 Mark S. Klempner, 10 Peter J. Krause, 8 Johan S. Bakken, 11 Franc Strle, 13 Gerold Stanek, 14 Linda Bockenstedt, 7 Durland Fish, 6 J. Stephen Dumler, 12 and Robert B. Nadelman 1 Divisions of 1 Infectious Diseases and 2 Allergy, Immunology, and Rheumatology, Department of Medicine, New York Medical College, Valhalla, and 3 New York University School of Medicine, New York, New York; 4 Atlantic Neuroscience Institute, Summit, New Jersey; Departments of 5 Pediatrics and 6 Epidemiology and Public Health and 7 Section of Rheumatology, Department of Medicine, Yale University School of Medicine, New Haven, and 8 Department of Pediatrics, University of Connecticut School of Medicine and Connecticut Childrens Medical Center, Hartford; 9 Division of Rheumatology, Allergy, and Immunology, Massachusetts General Hospital, Harvard Medical School, and 10 Boston University School of Medicine and Boston Medical Center, Boston, Massachusetts; 11 Section of Infectious Diseases, St. Lukes Hospital, Duluth, Minnesota; 12 Division of Medical Microbiology, Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, Maryland; 13 Department of Infectious Diseases, University Medical Center, Ljubljana, Slovenia; and 14 Medical University of Vienna, Vienna, Austria Evidence-based guidelines for the management of patients with Lyme disease, human granulocyticanaplasmosis (formerly known as human granulocytic ehrlichiosis), and babesiosis were prepared by an expert panel of the Infectious Diseases Society of America. These updated guidelines replace the previous treatment guidelines published in 2000 (Clin Infect Dis 2000; 31[Suppl 1]:114). The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. For each of these Ixodes tickborne infections, information is provided about prevention, epidemiology, clinical manifestations, diagnosis, and treatment. Tables list the doses and durations of antimicrobial therapy recommended for treatment and prevention of Lyme disease and provide a partial list of therapies to be avoided. A definition of postLyme disease syndrome is proposed. EXECUTIVE SUMMARY Background Lyme disease is the most common tickborne infection in both North America and Europe. In the United Received 21 August 2006; accepted 21 August 2006; electronically published 2 October 2006....
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