Journal of the American Medical Association   |  March 9, 2009

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THE INFECTIOUS DISEASES SOCIETY OF AMERICA (IDSA) issued updated clinical practice guidelines in 2006 for the diagnosis and treatment of Lyme disease. Within days, the Connecticut attorney general launched an investigation, alleging IDSA had violated state antitrust law by recommending against the use of longterm antibiotics to treat “chronic Lyme disease (CLD),” a label applied by advocates to a variety of nonspecific symptoms for which frequently no evidence suggests the etiologic agent of Lyme disease is responsible. The IDSA was forced to settle the claim to avoid exorbitant litigation costs, even though the society’s guidelines were based on sound
science. The case exemplifies the politicization of health policy, with elected officials advocating for health policies against the weight of scientific evidence.

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