Lyme disease

Recommendation ID: NG95/4
Question: Antimicrobial management of Lyme disease:- What are the most clinically and cost-effective treatment options for different clinical presentations of Lyme disease in the UK?
Any explanatory notes (if applicable): Why this is important:- The evidence on the effectiveness of antimicrobial treatment regimens used in different presentations of Lyme diseases is of poor quality, out-dated and often based on small studies. No relevant cost-effectiveness evidence was identified. A series of prospective multicentre studies is needed to compare the clinical and cost effectiveness of different dosages and length of treatments needed and the clinical and cost effectiveness of oral compared with intravenous treatments for different presentations of Lyme disease. This is felt to be of high priority because it has enormous implications for people with Lyme disease and for NHS costs.
There is currently insufficient quality evidence on the most effective drug and dose, and the effectiveness of extended treatment or retreatment regimens in those with continuing symptoms remains uncertain, leading to multiple referrals in search of alternative diagnoses. Clarification could improve outcomes, reduce costs and may minimise unnecessary treatment.

Source guidance details

Is this a recommendation for the use of a technology only in the context of research?	No
Is it a recommendation that suggests collection of data or the establishment of a register?	No
Last Reviewed	30/04/2018