Expert Rev Anti Infect Ther. 2014 Sep; 12(9): 1103–1135.
Published online 2014 Jul 30. doi: 10.1586/14787210.2014.940900
Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease
1International Lyme and Associated Diseases Society,, PO Box 341461, Bethesda MD, 20827-1461,, USA
2LymeDisease.org,, PO Box 1352, Chico, CA 95927,, USA
3Partnership for Healing and Health Ltd,, PO Box 84, Wyoming, MN 55092,, USA
Copyright © Informa UK, Ltd.
This is an open-access article distributed under the terms of the CC-BY-NC-ND 3.0 License which permits users to download and share the article for non-commercial purposes, so long as the article is reproduced in the whole without changes, and provided the original source is credited.
Evidence-based guidelines for the management of patients with Lyme disease were developed by the International Lyme and Associated Diseases Society (ILADS). The guidelines address three clinical questions – the usefulness of antibiotic prophylaxis for known tick bites, the effectiveness of erythema migrans treatment and the role of antibiotic retreatment in patients with persistent manifestations of Lyme disease. Healthcare providers who evaluate and manage patients with Lyme disease are the intended users of the new ILADS guidelines, which replace those issued in 2004 (Exp Rev Anti-infect Ther 2004;2:S1–13). These clinical practice guidelines are intended to assist clinicians by presenting evidence-based treatment recommendations, which follow the Grading of Recommendations Assessment, Development and Evaluation system. ILADS guidelines are not intended to be the sole source of guidance in managing Lyme disease and they should not be viewed as a substitute for clinical judgment nor used to establish treatment protocols.
Keywords: antibiotic prophylaxis, antibiotics, erythema migrans, GRADE, Lyme disease, persistent disease, treatment
download complete guideline in .pdf format from above link
National Guidelines Clearinghouse
Evidence assessments and guideline recommendations in Lyme disease: the clinical management of known tick bites, erythema migrans rashes and persistent disease.