PHYSICIAN PREFERENCES IN THE DIAGNOSIS AND TREATMENT OF LYME-DISEASE IN THE UNITED-STATES

To assess physician preferences in the diagnosis and treatment of Lyme disease, questionnaires were sent to physicians in various Lyme disea se endemic areas in the U. S. Seventy-eight responses were analyzed, B oth ELISA and Western blot were ordered by 86% of responders. Fifty pe rcent of responders believed that 25% or more of patients who have Lym e disease were seronegative. The treatment was influenced by physician specialty. Antibiotic treatment for tick bite was prescribed by 20% o f responders, Erythema migrans rash was treated by all responders with out serologic confirmation. The median treatment duration of erythema migrans was 4 weeks. For post-erythema migrans Lyme disease, 43% of re sponders treat 3 months or more; for chronic Lyme disease, 57% of resp onders treat 3 months or more, Our survey documents significant differ ences between published recommendations and actual practices. Physicia n education and clinical trials are needed to clarify the reasons for these differences.