Antibiotic Maximalism: Legislative Assaults on the Evidence-Based Treatment of Lyme Disease
37 Pages Posted: 9 Apr 2012 Last revised: 31 Dec 2012
Date Written: April 7, 2012
Abstract
Amidst public-health efforts to prevent antibiotic-resistant pathogens by reining in excessive antibiotic use, several states have passed laws that legitimize intensive antibiotic regimens even when those regimens contradict the best available medical evidence. Although this unprecedented legislative activity has occurred in the context of a controversial medical diagnosis — chronic Lyme disease — the legal and political repercussions threaten the established role of state medical licensing boards in promoting evidence-based standardization of medical practice. The most intrusive of these statutes prevents state licensing boards from disciplining physicians who prescribe regimens of “long-term antibiotic therapy” that are specifically proscribed by mainstream clinical practice guidelines (CPG) on Lyme disease treatment. Such laws promote the view of non-standard practitioners who favor the intensive, maximalist use of antibiotics for a condition that mainstream physicians dispute even exists. In an attempt to protect unnecessary antibiotic regimens, recent legislation legitimizes a treatment paradigm that poses an undue risk of harm to individual patients, and also to the public health.
Keywords: evidence-based medicine, Lyme disease, clinical practice guidelines
JEL Classification: K32, I18
Suggested Citation: Suggested Citation