A law allowing the long-term use of antibiotics for the treatment of chronic Lyme disease has been approved by the Legislature and is awaiting Gov. Deval L. Patrick�s signature.
Currently, doctors in Massachusetts are prohibited from prescribing antibiotics to patients with the disease for longer than four weeks, because of complications associated with using antibiotics over a prolonged period of time, and controversy about the existence of a chronic form of Lyme disease, which is caused by a bacterium transmitted by deer ticks.
State Sen. Stephen M. Brewer, D-Barre, a sponsor of the bill, said the antibiotic provision is attached to the state budget for next fiscal year, although no funding is involved.
Mr. Brewer said as it stands now, doctors cannot treat patients based on their judgment, and must send patients out of state to get long-term antibiotics. A similar law, allowing long-term use, was passed in New Hampshire in February. Several other states already allow long-term treatment, he said.
Hundreds of cases of the disease, many in children, are reported annually in Massachusetts � in all areas of the state.
According to information from the state Department of Public Health, prompt antibiotic treatment during the early stage of the disease prevents serious problems later on. The initial sign, which occurs days or weeks after a bite from an infected tick, is a doughnut-like rash appearing where the tick was attached. Flu-like symptoms such as fever, headache, stiff neck, aches and fatigue may also be present.
About 60 percent of those with untreated Lyme disease develop arthritis in the knees, elbows and wrists, which is often chronic. Other long-term effects of untreated Lyme disease include nervous system problems such as meningitis, facial weakness (Bell�s palsy), and weakness in the arms, legs, hands, and feet. Those symptoms can develop months or years after the initial infection.
Usually, Lyme disease can be successfully treated with four weeks of antibiotics.
According to the U.S. Centers for Disease Control and Prevention, antibiotic treatment above and beyond one repeat, four-week round has not been shown to be beneficial and has been linked to serious complications, such as allergic reactions to antibiotics.
There is a divide among health care professionals on how to treat Lyme disease that persists beyond a second round of antibiotics. CDC literature says much of the controversy revolves around whether symptoms reflect continued infection after treatment, and if the Lyme disease bacterium, Borrelia burgdorferi, can even exist in a chronic state following initial antibiotic treatment.
Mr. Brewer, who was horrified when he learned of the long-term consequences of untreated Lyme disease after watching a 90-minute video on the topic given to him by constituents, contends that treatment should be left up to a patient�s doctor.
�It�s a devastating, life-changing, debilitating long-term illness,� he said Monday, pointing out that the Association of American Physicians has endorsed the proposed law.