Australian National University, Canberra, ACT
ACT Pathology, Canberra Hospital, Canberra, ACT.
Med J Aust. 2016 Nov 7;205(9):413-417. doi: 10.5694/mja16.00824.
There is no convincing evidence that classic Lyme disease occurs in Australia, nor is there evidence that the causative agent, Borrelia burgdorferi, is found in Australian animals or ticks. Lyme disease, however, can be acquired overseas but diagnosed in Australia; most people presenting with laboratory-confirmed Lyme disease in Australia were infected in Europe. Despite the lack of evidence that Lyme disease can be acquired in Australia, growing numbers of patients, their supporters, and some politicians demand diagnoses and treatment according to the protocols of the "chronic Lyme disease" school of thought. Antibiotic therapy for chronic "Lyme disease-like illness" can cause harm to both the individual (eg, cannula-related intravenous sepsis) and the broader community (increased antimicrobial resistance rates). Until there is strong evidence from well performed clinical studies that bacteria present in Australia cause a chronic debilitating illness that responds to prolonged antibiotics, treating patients with "Lyme disease-like illness" with prolonged antibiotic therapy is unjustified, and is likely to do much more harm than good.
没有令人信服的证据表明经典莱姆病发生在澳大利亚，也没有证据表明病原体伯氏疏螺旋体存在于澳大利亚的动物或蜱虫中。然而，莱姆病可以在海外感染，但在澳大利亚诊断；在澳大利亚，大多数经实验室确诊的莱姆病患者是在欧洲感染的。尽管没有证据表明可以在澳大利亚感染莱姆病，但越来越多的患者、他们的支持者和一些政客根据“慢性莱姆病”学派的观点要求进行诊断和治疗。抗生素治疗慢性“类莱姆病”可能会对个人（例如，与导管相关的静脉败血症）和更广泛的社区（抗生素耐药率增加）造成伤害。在具有良好临床研究的强有力证据表明澳大利亚存在的细菌引起慢性使人衰弱的疾病并对长期抗生素治疗有反应之前，用长期抗生素治疗“类莱姆病”的患者是不合理的，而且很可能弊大于利。
