The Infectious Diseases Society of America (IDSA) is a medical association representing physicians, scientists and other health care professionals who specialize in infectious diseases. As of 2010, IDSA had approximately 9,000 members.[1] IDSA’s stated purpose is to improve the health of individuals, communities, and society by promoting excellence in patient care, education, research, public health, and prevention relating to infectious diseases.
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IDSA publishes the following medical journals:
The IDSA holds an annual meeting featuring presentations by experts in various aspects of infectious diseases, as well as original research abstracts and panel discussions.[2] The IDSA also issues clinical practice guidelines, advocates the development of new antimicrobial drugs and attention to the problem of antibiotic resistance, and promotes the scientific study of vaccination and access to important childhood vaccines. The Society sponsors the HIV Medicine Association (HIVMA), an organization of HIV researchers and specialists, and funds research fellowships for junior investigators in infectious diseases.[1]
The IDSA's policies on the treatment of Lyme disease, and in particular so-called "chronic Lyme disease", have proven to be controversial. The IDSA recommends against long-term antibiotic treatment for Lyme disease, arguing that it is ineffective and potentially harmful.[3] The American Academy of Neurology and National Institutes of Health similarly recommend against such treatment.[4][5] However, some believe that chronic Lyme disease is responsible for a range of medically unexplained symptoms, sometimes in people without any evidence of past infection.[6] Groups of patients, patient advocates, and physicians who support the concept of chronic Lyme disease have organized to lobby for recognition of this diagnosis, as well as to argue for insurance coverage of long-term antibiotic therapy.[7] Such groups have been critical of the IDSA guidelines on Lyme disease. Both sides of the argument were outlined in the 2008 American documentary film Under Our Skin.
In 2006, Connecticut Attorney General Richard Blumenthal announced an antitrust investigation against the IDSA, accusing the IDSA Lyme disease panel of undisclosed conflicts of interest and of unduly dismissing alternative therapies and "chronic" Lyme disease. Blumenthal's investigation was closed on May 1, 2008 without charges when the IDSA agreed to submit its guidelines for review by a panel of independent scientists and physicians.[8] Views on the motivation and outcome of the investigation varied. Blumenthal's press release described the agreement as a vindication of his investigation and repeated his conflict-of-interest allegations.[9] The IDSA pointed to the closure of the investigation without charges, and the fact that the medical validity of the IDSA guidelines was not challenged.[10] The IDSA cited mounting legal costs and the difficulty of presenting scientific arguments in a legal setting as their rationale for accepting the settlement.[11]
The Journal of the American Medical Association described Blumenthal's investigation of the IDSA as an example of the "politicization of health policy" against the weight of scientific evidence, and voiced concern over a chilling effect on future decisions by medical associations.[12]
Pursuant to their agreement with Blumenthal the IDSA Lyme Disease Guidelines Review Panel was convened in 2009. Prospective panelists were vetted by noted medical ethicist Howard Brody, MD, PhD, and excluded for conflict of interest if they reported more than $10,000 in income per year from treating patients for Lyme disease. The Final Report of the Review Panel, released on April 22, 2010, concurred with all recommendations published in the 2006 Guidelines, with unanimous votes on 68 of 69 recommendations reviewed.[13] This report, which was generated after review of more than 1000 references including public input and testimony by experts, concurred with consensus statements by numerous American and European medical societies that "chronic Lyme disease" and "post Lyme syndrome" lack a definition and convincing biological evidence. Further, the report emphasized that several prospective clinical trials of prolonged antibiotic therapy for persistently symptomatic patients uniformly showed evidence of harm without convincing evidence of benefit.