Survey of Lyme disease management in primary care in Poland

Background. Lyme disease (LD) is the most frequent tick-borne human disease in the world. In patients with nonspecific or late-onset symptoms, LD is still a challenge for family physicians (FPs). Some studies which have been published on LD management by FPs revealed a deviation from the guideline recommendations and clinical practice. Objectives. The aim of this study was to determine the common practice of FPs in the treatment of LD and whether these practices align with the guideline recommendations. Material and methods. The study consisted of a survey of 54 FPs, including 46 women and 8 men at a mean age of 39.4 +/- 10 years. An anonymous online questionnaire was used. The questionnaire was based on the guidelines for diagnosing and treating LD. Results. Most of the respondents work in a city (63%) or a small town (22.2%) 96.3% of them practice in primary care. 70.4% of the FPs had experienced a tick bite and 3.7% of them developed LD. 22.2% reported Lyme disease in their family. All of the respondents indicated erythema migrans (EM) as a characteristic symptom of LD, but only 3.7% of them reported that they would send their patients for serological testing 18.5% of FPs considered seropositivity to be an indication for prescribing antibiotics 85.2% of FPs correctly classified whether other than EM signs and symptoms were related to LD. 85.2% of the respondents said they would report LD to the Polish Food Safety and Inspection Service. Conclusions. Our study did not reveal a major deviation from the guideline recommendations. We found some FP misinterpretation, such as serology testing or antibiotherapy for asymptomatic patients. FPs should be trained at the clinical and epidemiological level. Up-to-date guidelines should be provided to FPs in order to limit inappropriate practices.