As Spring is reportedly here and warmer weather hopefully on the way, I appreciate staff writer Lindsay Tice addressing the topic of Lyme disease (March 30). However, I would like to help clarify some of the issues she raises.
Her article implies that the medical community is split regarding the diagnosis and treatment of Lyme disease. From where I sit, most of the primary care practitioners and infectious disease specialists in this community have a similar approach to the prevention, diagnosis and treatment of Lyme disease.
Tice stated that I am more cautious than “even the conservative Infectious Disease guidelines” in terms of post-tick bite prophylaxis when, in fact, my approach is exactly what is suggested by the IDSA and the CDC — treatment with a single dose of antibiotics if we are sure that the tick was a deer tick and that it had been attached for greater than 36-48 hours.
I also take issue with the characterization of some practitioners who treat Lyme aggressively with prolonged oral or intravenous antibiotics as being “Lyme literate.” I would argue just the opposite — that many of those practices do not meet the current standard of care.
The prevention and treatment of disease is often a moving target, which can be frustrating for patients and practitioners alike. Three weeks ago, saturated fats were killers; this week, maybe not so bad for you.
However, as medicine lurches forward, it is imperative that we do our best to adhere to scientific methods — the best of which are controlled, double-blinded studies and from these, try to identify best practices with the understanding that the recommendations will likely change as science and medicine wend their way forward.
When medical practitioners ignore the best current understanding of a disease state and its treatment, the patient is not being well-served.
Yes, there is an art to the practice of medicine which involves listening to the patient, empathy and looking at the big picture, but we are heading down a dangerous road that serves our patients poorly when we start to ignore the best available science.
Seth Gordon, M.D., Lewiston
Send questions/comments to the editors.
