We recommend against burning an attached tick (with a match or other heat device) or applying noxious chemicals or petroleum products to coax its detachment (good practice statement).We recommend promptly removing attached ticks by mechanical means using a clean fine-tipped tweezer (or a comparable device) inserted between the tick body and the skin (good practice statement).For the prevention of tick bites, we recommend N,N-Diethyl-meta-toluamide (DEET), picaridin, ethyl-3-(N-n-butyl-N-acetyl) aminopropionate (IR3535), oil of lemon eucalyptus (OLE), p-methane-3,8-diol (PMD), 2-undecanone, or permethrin (strong recommendation, moderate-quality evidence).Individuals at risk of exposure should implement personal protective measures to reduce the risk of tick exposure and infection with tick-borne pathogens (good practice statement).Which measures should be used to prevent tick bites and tick-borne infections? Key words: Lyme, Lyme disease, tick, tick-borne, tick-borne infection, neurology, rheumatology, cargiology, dermatology Recommendations (Abridged) A detailed description of background, methods, evidence summary and rationale that support each recommendation, and knowledge gaps can be found online in the full text. The panel followed a systematic process used in the development of other IDSA, AAN, and ACR clinical practice guidelines, which included a standardized methodology for rating the certainty of the evidence and strength of recommendation using the GRADE approach (Grading of Recommendations Assessment, Development, and Evaluation) (see Figure 1). Summarized below are the 2020 recommendations for the prevention, diagnosis, and treatment of Lyme disease. The target audience for this guideline includes primary care physicians and specialists caring for this condition such as infectious diseases specialists, emergency physicians, internists, pediatricians, family physicians, neurologists, rheumatologists, cardiologists and dermatologists in North America. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines. The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). Paul M Lantos, Jeffrey Rumbaugh, Linda K Bockenstedt, Yngve T Falck-Ytter, Maria E Aguero-Rosenfeld, Paul G Auwaerter, Kelly Baldwin, Raveendhara R Bannuru, Kiran K Belani, William R Bowie, John A Branda, David B Clifford, Francis J DiMario, Jr, John J Halperin, Peter J Krause, Valery Lavergne, Matthew H Liang, H Cody Meissner, Lise E Nigrovic, James (Jay) J Nocton, Mikala C Osani, Amy A Pruitt, Jane Rips, Lynda E Rosenfeld, Margot L Savoy, Sunil K Sood, Allen C Steere, Franc Strle, Robert Sundel, Jean Tsao, Elizaveta E Vaysbrot, Gary P Wormser, Lawrence S Zemelįor the full document, including complete tables and references, please visit the Oxford University Press website.Ī summary guideline for clinicians may be found here. Medical Education Community of PracticeĬlinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme DiseaseĬlinical Infectious Diseases, Volume 72, Issue 1, 1 January 2021, Pages e1-e48,.Fellows-In-Training Career & Education Center.myIDSA Practice Managers Community Opt-in Form.Antimicrobial Stewardship Centers of Excellence Program.
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