Randomized Controlled Trial of Azithromycin versus Doxycycline or Chloramphenicol for Treatment of Uncomplicated Pediatric Scrub Typhus
Chulapong Chanta MD*, Piti Phloenchaiwanit MD*
Affiliation : * Department of Pediatrics, Chiangrai Prachanukroh Hospital, Chiang Rai, Thailand
Objective : To evaluate the efficacy and safety of azithromycin for treatment of uncomplicated pediatric scrub typhus.
Material and Method: A randomized controlled trial was performed. We compared azithromycin with doxycycline or
chloramphenicol in uncomplicated pediatric scrub typhus from inpatient pediatric department of Chiangrai Prachanukroh
Hospital. The primary outcome was cure rate at day 3. The secondary outcomes were timing to defervescence within 72 hours,
side effects, and relapsed rate. We compared data between both groups with Fisher’s exact test or Mann-Whitney U test,
and failure rate was demonstrated by Kaplan-Meier survival curve and Log-rank test.
Results : We included 57 patients, of whom, 28 were assigned to doxycycline or chloramphenicol (control group) and 29 to
azithromycin (study group). The baseline characteristics of both groups were similar. The cure rate was 85.7% in the
doxycycline or chloramphenicol group, as compared to 79.3% in the azithromycin group (p = 0.73), and a median time to
defervescence was 30 hours (IQR 21, 48) vs. 36 hours (IQR 20, 68) respectively (p = 0.166). There was a little minor side
effect in azithromycin group. No relapsed was found in either groups.
Conclusion : Azithromycin was as effective as doxycycline or chloramphenicol in treatment of uncomplicated pediatric
scrub typhus.
Keywords : Scrub typhus, Doxycycline, Chloramphenicol, Azithromycin
