Quality standard
Quality statement 3: Antibiotic treatment
Quality statement 3: Antibiotic treatment
Quality statement
People with Lyme disease have initial antibiotic treatment, with the antibiotic, dosage and duration determined by their symptoms.
Rationale
Prompt treatment of Lyme disease with an initial antibiotic at adequate dosage and duration, chosen according to the person's symptoms (for example, presentation with erythema migrans or fever) and in line with the recommendations on antibiotic treatment in the NICE guideline on Lyme disease, will stop or reduce the symptoms of Lyme disease and may also prevent the relapse of symptoms.
Quality measures
Structure
Evidence that local formularies align with NICE's recommendations on antibiotic treatment for Lyme disease, so that healthcare professionals in primary and secondary care prescribe an antibiotic to people with Lyme disease according to their symptoms.
Data source: Local data collection, for example, local formularies.
Process
a) Proportion of people diagnosed with Lyme disease who are given the initial antibiotic recommended by NICE for their symptoms.
Numerator – the number in the denominator who are given the antibiotic recommended by NICE for their symptoms.
Denominator – the number of people diagnosed with Lyme disease.
Data source: Local data collection, for example, a case note review of patient records.
b) Proportion of people diagnosed with Lyme disease who are given the initial antibiotic recommended by NICE for their symptoms at the recommended dosage.
Numerator – the number in the denominator who are given the antibiotic recommended by NICE for their symptoms at the recommended dosage.
Denominator – the number of people diagnosed with Lyme disease.
Data source: Local data collection, for example, a case note review of patient records.
c) Proportion of people diagnosed with Lyme disease who are given the initial antibiotic recommended by NICE for their symptoms for the recommended duration.
Numerator – the number in the denominator who are given the antibiotic recommended by NICE for their symptoms for the recommended duration.
Denominator – the number of people diagnosed with Lyme disease.
Data source: Local data collection, for example, a case note review of patient records.
What the quality statement means for different audiences
Service providers (primary care and NHS hospital trusts) ensure that they develop or have access to a local antibiotic formulary that is aligned with NICE's recommendations, according to the symptoms of Lyme disease.
Healthcare professionals (such as GPs, prescribers in A&E departments, and specialists in secondary and tertiary care) treat Lyme disease with antibiotics. They follow local antibiotic formularies to ensure that they prescribe the antibiotic, dosage and duration that is aligned with NICE's recommendations, as determined by the person's symptoms.
Commissioners (such as NHS England and clinical commissioning groups) ensure that service specifications require antibiotic treatment that is aligned with NICE's recommendations to be prescribed to people with Lyme disease according to their symptoms.
People diagnosed with Lyme disease have antibiotic treatment that is chosen according to their symptoms. This is to make sure that they are given the antibiotics recommended by NICE, at the right dose and for long enough to treat their symptoms.
Source guidance
Lyme disease. NICE guideline NG95 (2018), recommendations 1.3.4 and 1.3.5
Definition of terms used in this quality statement
Antibiotic treatment determined by their symptoms
Recommended antibiotics, dosages and duration of initial treatment of Lyme disease, according to the person's symptoms, are given in tables 1 and 2 of NICE's guideline on Lyme disease. [NICE's guideline on Lyme disease, recommendations 1.3.4 and 1.3.5]