I would like to point out that the Klempner trial is ancient history now, was said at the time to be the first of several trials (after patient advocates pointed out its flaws), but no further trials were scheduled. Klempner’s subjects were people who had already had extended treatment, comparable to what they were given in the trial, so this was not new information gathered, but a repeat. A persistent infection will not be cured by his regimen. Yet this trial is cited as part of your evidence for leaving lyme patients untreated after they are not cured by a short term therapy designed for acute cases, not chronic ones.
The way you know whether a treatment is working is to see what happens to the symptoms. If after the treatment, these symptoms decline but then are renewed, they are still infected. Further treatment that does the same thing, after short or longer periods of time, is evidence that treatment does work on some of the bacteria, but not the persisters. This is why the symptoms recur. It is not hard to understand then that treatment is still needed to maintain some functionality, until a more effective one that works against persisters is found. To do otherwise, is a scientific and public health injustice. There are many health problems where cure is not an option, but no one then throws these people on the trashpile.
Furthermore, at the time the Klempner trial occurred, there was less recognition of the role of coinfections, and the testing for those was and still is not thorough. How that affected his results is unknown but cannot help but be involved.
In the introductory section, it is stated that the guidelines are voluntary, but the IDSA has done everything in their power, and joined with the CDC to ensure that anyone who does not march in lockstep, or goosestep, will find themselves in trouble and frequently without a medical license anymore. In fact, one of the guideline authors has testified against doctors that have found the guidelines to be wrong in many ways, and used their professional judgement for better treatment of seriously ill patients. The fact that their treatments result in improvements is never taken into consideration! Dr. Wormser, though, is said not to have conflicts of interest!
If the IDSA is so far from truth in its lyme guidelines, why should we have any confidence that the other guidelines are not also seriously flawed and dishonest? Do you not realize what this is doing to public confidence in medicine? Or maybe you think holding all the cards, you do not have to care and are above the law. I think the people responsible for this should have found other fields of endeavor where their lack of competence would not do so much damage to so many people. If thousands of patients and their families say you are wrong, you should find out where and consult those with the actual evidence: the doctors and patients who have a vast amount of experience and are now shut out.