Evidence map›Paper›PMID 28676925›Full record

ArticleJournal of neurology2017

Lyme neuroborreliosis: do we treat according to guidelines?

Åslaug R Lorentzen, Kristine J N Forselv, Geir Helgeland, Rigmor E Salvesen, Geir Sand, Heidi Ø Flemmen, Margrete H Bø, Ludmila Nordaa, Anna K Roos, Marion W Jim and 6 more

Abstract read
PubMed Publisher
In one paragraph

Article in Journal of neurology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 12 institutions in 1 country.

Åslaug R LorentzenDepartment of Neurology, Sørlandet Hospital Trust, PO Box 416, 4604, Kristiansand, Norway. aslaug.rudjord.lorentzen@sshf.no.
Kristine J N ForselvDepartment of Neurology, Sørlandet Hospital Trust, PO Box 416, 4604, Kristiansand, Norway.
Geir HelgelandDepartment of Neurology, Møre and Romsdal Hospital Trust, Molde, Norway.
Rigmor E SalvesenDepartment of Neurology, Stavanger University Hospital, Stavanger, Norway.
Geir SandDepartment of Infectious Diseases, Stavanger University Hospital, Stavanger, Norway.
Heidi Ø FlemmenDepartment of Neurology, Telemark Hospital Trust, Skien, Norway.
Margrete H BøDepartment of Neurology, Oslo University Hospital, Oslo, Norway.
Ludmila NordaaDepartment of Neurology, Stavanger University Hospital, Stavanger, Norway.
Anna K RoosDepartment of Neurology, St. Olavs University Hospital, Trondheim, Norway.
Marion W JimDepartment of Neurology, Vestre Viken Trust, Drammen, Norway.
Jone F OweDepartment of Neurology, Haukeland University Hospital, Bergen, Norway.
Kaja B NyquistDepartment of Neurology, Innlandet Hospital Trust, Lillehammer, Norway.
Stephan SchülerDepartment of Neurology, Nord-Trøndelag Trust, Namsos, Norway.
Randi EikelandDepartment of Neurology, Sørlandet Hospital Trust, PO Box 416, 4604, Kristiansand, Norway.
Åse MyglandDepartment of Neurology, Sørlandet Hospital Trust, PO Box 416, 4604, Kristiansand, Norway.
Unn LjøstadDepartment of Neurology, Sørlandet Hospital Trust, PO Box 416, 4604, Kristiansand, Norway.
Sørlandet Sykehus · NOStavanger University Hospital · NOFonna Hospital TrustHaukeland University Hospital · NOInnlandet Hospital Trust · NOMolde Hospital · NONamsos Hospital · NOOslo University Hospital · NOØstfold Hospital Trust · NOTelemark Hospital · NOUniversity of Bergen · NOVestre Viken Hospital Trust · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Evidence-based guidelines, published in 2010, equate the efficacy of oral and intravenous antibiotics and recommend treatment duration of 2 weeks in early Lyme neuroborreliosis (LNB) without encephalitis or myelitis. Further, the Norwegian health authorities give a general advice to choose oral rather than intravenous administration when proven effective, due to lower costs, fewer risks, and reduced patient inconvenience. In this study we aimed to chart LNB treatment practice in Norway and compare it to these recommendations. Adult patients diagnosed with definite LNB between 2007 and 2013 in 11 different hospitals in the four health regions in Norway were invited to answer a questionnaire regarding duration and administration of antibiotic treatment. A total of 253 patients answered. Median age at diagnosis was 59 years (range 19-83), and 125 (49%) were women. Duration of treatment was 1 week in 7 (3%) patients, 2 weeks in 81 (32%), 3 weeks in 62 (25%), 4 weeks in 48 (19%), 5 weeks in 12 (5%), ≥6 weeks in 29 (12%), and unknown in 14 (6%). Treatment was given orally in 77 (30%) patients, intravenously in 110 (44%), both orally and intravenously in 65 (26%), and unknown in one. Treatment practices differed between the health regions (p = 0.002). During the study period, there were no significant time trend neither with respect to proportion of patients treated for only 2 weeks (OR 0.899, p = 0.109) nor with respect to proportion of patients treated exclusively with oral antibiotics (OR 1.131, p = 0.074). In conclusion, there seem to be a gap between evidence-based recommendations and treatment practice of LNB in Norway.

Indexed as

Borrelia burgdorferi GroupAdultAgedAged, 80 and overAnti-Bacterial AgentsFemaleHumansLyme NeuroborreliosisMaleMiddle AgedNorwayPractice Guidelines as TopicRetrospective StudiesSurveys and QuestionnairesYoung AdultAnti-Bacterial AgentsAntibiotic treatmentBorreliaGuidelinesLyme neuroborreliosisTick-borne disease

Identifiers

PMID28676925
OpenAlexW2730088492

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.