Ziska M H, Donta S T, Demarest F C
Lyme Disease Foundation, Hartford, Connecticut 06103-2610, USA.
Infection. 1996 Mar-Apr;24(2):182-6. doi: 10.1007/BF01713336.
To assess physician preferences in the diagnosis and treatment of Lyme disease, questionnaires were sent to physicians in various Lyme disease endemic areas in the U.S. Seventy-eight responses were analyzed. Both ELISA and Western blot were ordered by 86% of responders. Fifty percent of responders believed that 25% or more of patients who have Lyme disease were seronegative. The treatment was influenced by physician specialty. Antibiotic treatment for tick bite was prescribed by 20% of responders. Erythema migrans rash was treated by all responders without serologic confirmation. The median treatment duration of erythema migrans was 4 weeks. For post-erythema migrans Lyme disease, 43% of responders treat 3 months or more; for chronic Lyme disease, 57% of responders treat 3 months or more. Our survey documents significant differences between published recommendations and actual practices. Physician education and clinical trials are needed to clarify the reasons for these differences.
为评估医生在莱姆病诊断和治疗方面的偏好，向美国各莱姆病流行地区的医生发放了调查问卷。对78份回复进行了分析。86%的回复者同时开具了酶联免疫吸附测定（ELISA）和免疫印迹法检测。50%的回复者认为，25%或更多的莱姆病患者血清学检测呈阴性。治疗受到医生专业的影响。20%的回复者会为蜱虫叮咬开具抗生素治疗。所有回复者在未进行血清学确认的情况下就对游走性红斑皮疹进行了治疗。游走性红斑的中位治疗时长为4周。对于红斑移行后莱姆病，43%的回复者治疗3个月或更长时间；对于慢性莱姆病，57%的回复者治疗3个月或更长时间。我们的调查记录了已发表的建议与实际做法之间的显著差异。需要开展医生教育和临床试验来阐明这些差异的原因。
