• A Lieber M'bomeyo, G Hedelin, and D Lipsker.
• Clinique dermatologique des Hôpitaux universitaires, Strasbourg.
• Presse Med. 2003 Nov 22; 32 (37 Pt 1): 1734-6.

ObjectiveDetermine the level of knowledge of the general practitioners on the early phase of Lyme borreliosis in an endemic area and notably to define the attention paid to the use and interpretation of serologic investigations for the treatment of patients with erythema migrans.MethodThis was a prospective study conducted from May 15 to June 31, 2001 among 106 randomly selected general practitioners installed in Strasbourg, France. The practitioners were all interviewed in their private practice and by the same person. Three standardized questions were asked, evaluating their level of specific medical training on Lyme borreliosis as well as their practice regarding treatment and diagnosis of erythema migrans.ResultsOne third of the general practitioners had already accomplished a continued medical education course on Lyme borreliosis. Half of them considered that the diagnosis of erythema migrans was clinical, while the other half believed that serological confirmation was mandatory. However, the answers of those having received specific education on borreliosis were right (p=0.0079) since in this sub-group 72% considered that the diagnosis was exclusively based on clinical examination, versus 41% of the untrained physicians. Eighty-eight percent used the recommended antibiotic regimens to treat erythema migrans. Three practitioners proposed an inefficient treatment that had exposed the patients to the risk of extra-cutaneous complications of the disease.ConclusionFifty percent of the general practitioners working in endemic areas for Lyme borreliosis still believe that seropositivity against Borrelia burgdorferi is required to diagnose erythema migrans, which is untrue. However, this study shows that a specific education on Lyme borreliosis would significantly improve this score.

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