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IDSA Practice Guidelines

Practice guidelines are systematically developed statements to assist practitioners and patients in making decisions about appropriate health care for specific clinical circumstances. [Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990]

Attributes of good guidelines include validity, reliability, reproducibility, clinical applicability, clinical flexibility, clarity, multidisciplinary process, review of evidence, and documentation. [Institute of Medicine Committee to Advise the Public Health Service on Clinical Practice Guidelines, 1990]

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Lyme Disease

Status: Update in Progress

Lyme disease is the most common tick-borne infection in both North America and Europe. In the United States, Lyme disease is caused by Borrelia burgdorferi, which is transmitted by the

Lyme disease is the most common tick-borne infection in both North America and Europe. In the United States, Lyme disease is caused by Borrelia burgdorferi, which is transmitted by the bite of the tick species Ixodes scapularis and Ixodes pacificus. Clinical manifestations most often involve the skin, joints, nervous system, and heart. Full textApproximately every 12 – 18 months following publication, IDSA evaluates its guidelines for the need for update.  Because several years have passed since the last update, IDSA determined that a new undertaking for Lyme disease guidelines was needed. In order to develop a more focused and manageable guideline than the previous guideline which had a very broad scope, the IDSA has decided to approach this guideline topic differently by separating the topic into distinct guidelines.  This is a practice that IDSA has implemented across many of its guidelines where the scope has been expansive. The first of these guideline topics to be addressed will be on the prevention, diagnosis, and treatment of Lyme disease.  This guideline is being developed jointly with the American Academy of Neurology and the American College of Rheumatology.  Other collaborators on the guideline include panel members from the following: American Academy of Family Physicians (AAFP), American Academy of Pediatrics – Committee on Infectious Diseases (AAP-COID), American Academy of Pediatrics – Section on Emergency Medicine (AAP-EM), American College of Physicians (ACP), Association of Medical Microbiology and Infectious Diseases – Canada (AMMI-CA), Child Neurology Society (CNS), Pediatric Infectious Diseases Society (PIDS), Entomological Society of America (ESA), European Society of Clinical Microbiology and Infectious Diseases (ESCMID).  Individuals from the disciplines of cardiology, microbiology and pathology as well as a consumer representative and a methodologist with expertise in GRADE are also among the members of the guideline development panel. In contrast to the 2006 IDSA guidelines, this guideline will not provide comprehensive coverage of Anaplasma phagocytophilum and Babesia microti outside the context of co-infections. Those pathogens will be treated more comprehensively in separate, forthcoming clinical guidelines. Information on the status of these updates can be found here, within the Practice Guidelines/Infections by Organism/Bacteria section of the IDSA website. *Projected publication, Fall 2018

Asymptomatic Bacteriuria

Status: Update in Progress

The purpose of this guideline is to provide recommendations for diagnosis and treatment of asymptomatic bacteriuria in adult populations 18 years of age. The recommendations were developed on the basis

The purpose of this guideline is to provide recommendations for diagnosis and treatment of asymptomatic bacteriuria in adult populations 18 years of age. The recommendations were developed on the basis of a review of published evidence, with the strength of the recommendation and quality of the evidence graded using previously described Infectious Diseases Society of America (IDSA) criteria (table 1) [1]. Recommendations are relevant only for the treatment of asymptomatic bacteriuria and do not address prophylaxis for prevention of symptomatic or asymptomatic urinary infection. This guideline is not meant to replace clinical judgment.Screening of asymptomatic subjects for bacteriuria is appropriate if bacteriuria has adverse outcomes that can be prevented by antimicrobial therapy [2]. Outcomes of interest are short term, such as symptomatic urinary infection (including bacteremia with sepsis or worsening functional status), and longer term, such as progression to chronic kidney disease or hypertension, development of urinary tract cancer, or decreased duration of survival. Treatment of asymptomatic bacteriuria may itself be associated with undesirable outcomes, including subsequent antimicrobial resistance, adverse drug effects, and cost. If treatment of bacteriuria is not beneficial, screening of asymptomatic populations to identify bacteriuria is not indicated, unless performed in a research study to further explore the biology or clinical significance of bacteriuria. Thus, there are 2 topics of interest: whether asymptomatic bacteriuria is associated with adverse outcomes, and whether the interventions of screening and antimicrobial treatment improve these outcomes.Full textA correction has been published: Clin Infect Dis (2005) 40 (10): 1556. *Projected publication, Fall 2018

Outpatient Parenteral Anti-Infective Therapy (OPAT)

Status: Update in Progress

These guidelines were formulated to assist physicians and other health care professionals with various aspects of the administration of outpatient parenteral antimicrobial therapy (OPAT). Although there are many reassuring retrospective

These guidelines were formulated to assist physicians and other health care professionals with various aspects of the administration of outpatient parenteral antimicrobial therapy (OPAT). Although there are many reassuring retrospective studies on the efficacy and safety of OPAT, few prospective studies have been conducted to compare the risks and outcomes for patients who receive treatment as outpatients rather than as inpatients. Because truly evidence-based studies are lacking, the present guidelines are formulated from the collective experience of the committee members and advisors from related organizations.  Full text*Projected Publication, Spring 2018

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