The level of knowledge of general practitioners regarding the early phase of Lyme borreliosis. Survey conducted among 106 general practitioners
Lieber M'bomeyo, A.; Hedelin, G.; Lipsker, D.
Presse Medicale 32(37 Pt 1): 1734-1736
2003
ISSN/ISBN: 0755-4982 PMID: 14663387 Document Number: 557292
The aims of this study were to determine the knowledge level of general practitioners (GPs) regarding the early phase of Lyme disease in an endemic area, and to define the attention paid to the use and interpretation of serological investigations for the treatment of patients with erythema migrans (EM). This prospective study was conducted between 15 May and 31 June 2001, and included 106 randomly selected GPs from France. All GPs were interviewed, and 3 standardized questions were asked, evaluating their level of specific medical training on Lyme disease as well as their practice regarding the treatment and diagnosis of EM. One-third of the GPs had already accomplished a continued medical education course on Lyme disease. Half of them considered that the diagnosis of EM was clinical, while the other half believed that serological confirmation was mandatory. However, the answers of those who received specific education on Lyme disease were correct (P=0.0079), since in this subgroup, 72% considered that the diagnosis was exclusively based on clinical examination vs. 41% of the untrained GPs. Eighty-eight percent used the recommended antibiotic regimens to treat EM. Three practitioners proposed an inefficient treatment that had exposed the patients to the risk of extracutaneous complications of the disease. In conclusion, 50% of the GPs in this study still believe that seropositivity against Borrelia burgdorferi is required to diagnose EM, which is untrue. HOwever, this study shows that a specific education on Lyme disease would significantly improve this score.