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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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6 results found

Nervous System Lyme Disease

Status: Update in Progress, Endorsed

Objective: To provide evidence-based recommendations on the treatment of nervous system Lyme disease and post–Lyme syndrome. Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens

Objective: To provide evidence-based recommendations on the treatment of nervous system Lyme disease and post–Lyme syndrome. Three questions were addressed: 1) Which antimicrobial agents are effective? 2) Are different regimens preferred for different manifestations of nervous system Lyme disease? 3) What duration of therapy is needed? Methods: The authors analyzed published studies (1983–2003) using a structured review process to classify the evidence related to the questions posed. Results: The panel reviewed 353 abstracts which yielded 112 potentially relevant articles that were reviewed, from which 37 articles were identified that were included in the analysis. Conclusions: There are sufficient data to conclude that, in both adults and children, this nervous system infection responds well to penicillin, ceftriaxone, cefotaxime, and doxycycline (Level B recommendation). Although most studies have used parenteral regimens for neuroborreliosis, several European studies support use of oral doxycycline in adults with meningitis, cranial neuritis, and radiculitis (Level B), reserving parenteral regimens for patients with parenchymal CNS involvement, other severe neurologic symptomatology, or failure to respond to oral regimens. The number of children (8 years of age) enrolled in rigorous studies of oral vs parenteral regimens has been smaller, making conclusions less statistically compelling. However, all available data indicate results are comparable to those observed in adults. In contrast, there is no compelling evidence that prolonged treatment with antibiotics has any beneficial effect in post–Lyme syndrome (Level A).   *The updated Lyme Disease Guideline will address Nervous System Lyme. Projected publication: Fall 2018

Clostridium difficile

Status: Update in Progress

This guideline is designed to improve the diagnosis and management of Clostridium difficile infection (CDI) in adult patients. A case of CDI is defined by the presence of symptoms (usually diarrhea) and

This guideline is designed to improve the diagnosis and management of Clostridium difficile infection (CDI) in adult patients. A case of CDI is defined by the presence of symptoms (usually diarrhea) and either a stool test positive for C. difficile toxins or toxigenic C. difficile, or colonoscopic or histopathologic findings revealing pseudomembranous colitis. In addition to diagnosis and management, recommended methods of infection control and environmental management of the pathogen are presented. The recommendations are based on the best available evidence and practices, as determined by a joint Expert Panel appointed by SHEA and the Infectious Diseases Society of America (IDSA) (the SHEA-IDSA Expert Panel). The use of these guidelines can be impacted by the size of the institution and the resources, both financial and laboratory, available in the particular clinical setting. Full text*Projected publication, Winter 2018

Nontuberculous Mycobacterial (NTM) Diseases

Status: Update in Progress

The minimum evaluation of a patient suspected of nontuberculous mycobacterial (NTM) lung disease should include the following: (1) chest radiograph or, in the absence of cavitation, chest high-resolution computed tomography

The minimum evaluation of a patient suspected of nontuberculous mycobacterial (NTM) lung disease should include the following: (1) chest radiograph or, in the absence of cavitation, chest high-resolution computed tomography (HRCT) scan; (2) three or more sputum specimens for acid-fast bacilli (AFB) analysis; and (3) exclusion of other disorders, such as tuberculosis (TB). Clinical, radiographic, and microbiologic criteria are equally important and all must be met to make a diagnosis of NTM lung disease. *For information on the timing of future updates to this guideline, contact the ATS.

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

Control of Tuberculosis (TB)

Status: Current, Endorsed

During 1993–2003, incidence of tuberculosis (TB) in the United States decreased 44% and is now occurring at a historic low level (14,874 cases in 2003)... In this statement, the American

During 1993–2003, incidence of tuberculosis (TB) in the United States decreased 44% and is now occurring at a historic low level (14,874 cases in 2003)... In this statement, the American Thoracic Society (ATS), Centers for Disease Control and Prevention (CDC), and the Infectious Diseases Society of America (IDSA) propose recommendations to improve the control and prevention of TB in the United States and to progress toward its elimination. *For information on the timing of future updates to this guideline, contact the ATS.

Staph Aureus Bacteremia

Status: New Guideline in Development

*Projected Publication, Summer 2019

*Projected Publication, Summer 2019

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