Controlled Trial: 5-day Course of Rifampin Versus Doxycycline for the Treatment of Mild to Moderate Scrub Typhus

Dong-Min Kim

Status

Completed

Conditions

Scrub Typhus

Treatments

Drug: doxycycline

Drug: rifampin

Study type

Interventional

Funder types

Other

Identifiers

NCT00568711

IRB043-31

Details and patient eligibility

About

New antibiotics are required to have not only the antibacterial activity against doxycyline-resistant O. tsutsugamushi but also lower risk for resistance or any cross-resistance to others.

In this prospective, open-label, randomized trial, we enroll patients with mild-to-moderate scrub typhus. We compared the efficacy and safety of a 5-day rifampin therapy with those of a 5-day doxycycline therapy at Chosun University Hospital, or one of its two community-based affiliated hospitals which are all located in southwestern Korea between 2006 and 2009.

Enrollment

476 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Inclusion criteria were:

Adults aged 18 years or older
A fever of higher than 37.5°C
The concurrent presence of eschar or a maculopapular skin rash; and the clear presence of more than two symptoms such as headache, malaise, myalgia, coughing, nausea and abdominal discomfort.
Patients were hospitalized at Chosun University Hospital in Kwangju, Korea or one of its two community-based affiliated hospitals which are all located in southwestern Korea between 2006 and 2009.

Exclusion criteria

The exclusion criteria were:

An inability to take oral medications
Pregnancy
Hypersensitivity to the trial drugs
Previous drug therapy with potential antirickettsial activity (e.g., rifampicin, chloramphenicol, macrolides, fluoroquinolones or tetracyclines) within 48 h prior to admission
Severe scrub typhus (shock requiring vasopressor therapy for more than one hour
A stuporous or comatose level of consciousness
Respiratory failure requiring mechanical ventilation or renal failure requiring immediate dialysis) (4, 10).
For the differential diagnosis of scrub typhus from other diseases with similar symptoms (e.g., murine typhus, leptospirosis, hemorrhagic fever with renal syndrome and systemic lupus erythematosus), patients underwent diagnostic tests. We thus excluded patients with concurrent infections who had the risk of causing different outcomes.