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When Are Antibiotics for Lyme Disease Medically Necessary?
Date:6/5/2008

e doctors determine that a patient is in stage one or two of the disease, it can be easily treated with a two- to four-week course of oral antibiotics. Most doctors prescribe doxycycline, (for adults and children over eight years old) or amoxicillin or cefuroxime (for adults and children under eight). Usually -- but not always -- an early course of antibiotic treatment cures the disease. Even with proper treatment, patients who have Lyme disease may develop symptoms consistent with fibromyalgia or chronic fatigue syndrome. An active infection, however, often isn't the source of such symptoms.

Doctors unfamiliar with Lyme disease often misdiagnose it as multiple sclerosis, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome or other autoimmune and neurological diseases. Misdiagnosis, as well as delayed or inadequate treatment, may lead to the persistent third stage of the disease.

Without early and medically necessary antibiotic treatment, 10 to 15 percent of Lyme disease patients may display arthritic or even neurological complaints. And 80 percent of patients with Lyme disease develop malaise and fatigue similar to chronic fatigue syndrome. They also may display other symptoms unrelated to Lyme disease.

The current recommendations for diagnosis and care require either the bull's-eye rash or positive specific laboratory tests and only recognize false negatives during the early stages of the disease. The recommendations also suggest that post-Lyme disease syndromes don't respond to long-term antibiotic use.

For more information on leading-edge treatments and their medical necessity, check out http://www.allmedmd.com/peerpoints/cuttingedge/cutting_edge_email.htm. To find out more about the services that independent review organizations offer, go to AllMed's Website at http://www.allmedmd.
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SOURCE AllMed Healthcare Management
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