Tags

Type your tag names separated by a space and hit enter

Doxycycline versus azithromycin for treatment of leptospirosis and scrub typhus.
Antimicrob Agents Chemother. 2007 Sep; 51(9):3259-63.AA

Abstract

Leptospirosis and scrub typhus are important causes of acute fever in Southeast Asia. Options for empirical therapy include doxycycline and azithromycin, but it is unclear whether their efficacies are equivalent. We conducted a multicenter, open, randomized controlled trial with adult patients presenting with acute fever (<15 days), without an obvious focus of infection, at four hospitals in Thailand between July 2003 and January 2005. Patients were randomly allocated to receive either a 7-day course of doxycycline or a 3-day course of azithromycin. The cure rate, fever clearance time, and adverse drug events were compared between the two study groups. A total of 296 patients were enrolled in the study. The cause of acute fever was determined for 151 patients (51%): 69 patients (23.3%) had leptospirosis; 57 patients (19.3%) had scrub typhus; 14 patients (4.7%) had murine typhus; and 11 patients (3.7%) had evidence of both leptospirosis and a rickettsial infection. The efficacy of azithromycin was not inferior to that of doxycycline for the treatment of both leptospirosis and scrub typhus, with comparable fever clearance times in the two treatment arms. Adverse events occurred more frequently in the doxycycline group than in the azithromycin group (27.6% and 10.6%, respectively; P = 0.02). In conclusion, doxycycline is an affordable and effective choice for the treatment of both leptospirosis and scrub typhus. Azithromycin was better tolerated than doxycycline but is more expensive and less readily available.

Authors+Show Affiliations

Udonthani Hospital, Udonthani Province, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17638700

Citation

Phimda, Kriangsak, et al. "Doxycycline Versus Azithromycin for Treatment of Leptospirosis and Scrub Typhus." Antimicrobial Agents and Chemotherapy, vol. 51, no. 9, 2007, pp. 3259-63.
Phimda K, Hoontrakul S, Suttinont C, et al. Doxycycline versus azithromycin for treatment of leptospirosis and scrub typhus. Antimicrob Agents Chemother. 2007;51(9):3259-63.
Phimda, K., Hoontrakul, S., Suttinont, C., Chareonwat, S., Losuwanaluk, K., Chueasuwanchai, S., Chierakul, W., Suwancharoen, D., Silpasakorn, S., Saisongkorh, W., Peacock, S. J., Day, N. P., & Suputtamongkol, Y. (2007). Doxycycline versus azithromycin for treatment of leptospirosis and scrub typhus. Antimicrobial Agents and Chemotherapy, 51(9), 3259-63.
Phimda K, et al. Doxycycline Versus Azithromycin for Treatment of Leptospirosis and Scrub Typhus. Antimicrob Agents Chemother. 2007;51(9):3259-63. PubMed PMID: 17638700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Doxycycline versus azithromycin for treatment of leptospirosis and scrub typhus. AU - Phimda,Kriangsak, AU - Hoontrakul,Siriwan, AU - Suttinont,Chuanpit, AU - Chareonwat,Sompong, AU - Losuwanaluk,Kitti, AU - Chueasuwanchai,Sunee, AU - Chierakul,Wirongrong, AU - Suwancharoen,Duangjai, AU - Silpasakorn,Saowaluk, AU - Saisongkorh,Watcharee, AU - Peacock,Sharon J, AU - Day,Nicholas P J, AU - Suputtamongkol,Yupin, Y1 - 2007/07/16/ PY - 2007/7/20/pubmed PY - 2008/1/9/medline PY - 2007/7/20/entrez SP - 3259 EP - 63 JF - Antimicrobial agents and chemotherapy JO - Antimicrob Agents Chemother VL - 51 IS - 9 N2 - Leptospirosis and scrub typhus are important causes of acute fever in Southeast Asia. Options for empirical therapy include doxycycline and azithromycin, but it is unclear whether their efficacies are equivalent. We conducted a multicenter, open, randomized controlled trial with adult patients presenting with acute fever (<15 days), without an obvious focus of infection, at four hospitals in Thailand between July 2003 and January 2005. Patients were randomly allocated to receive either a 7-day course of doxycycline or a 3-day course of azithromycin. The cure rate, fever clearance time, and adverse drug events were compared between the two study groups. A total of 296 patients were enrolled in the study. The cause of acute fever was determined for 151 patients (51%): 69 patients (23.3%) had leptospirosis; 57 patients (19.3%) had scrub typhus; 14 patients (4.7%) had murine typhus; and 11 patients (3.7%) had evidence of both leptospirosis and a rickettsial infection. The efficacy of azithromycin was not inferior to that of doxycycline for the treatment of both leptospirosis and scrub typhus, with comparable fever clearance times in the two treatment arms. Adverse events occurred more frequently in the doxycycline group than in the azithromycin group (27.6% and 10.6%, respectively; P = 0.02). In conclusion, doxycycline is an affordable and effective choice for the treatment of both leptospirosis and scrub typhus. Azithromycin was better tolerated than doxycycline but is more expensive and less readily available. SN - 0066-4804 UR - https://www.unboundmedicine.com/medline/citation/17638700/Doxycycline_versus_azithromycin_for_treatment_of_leptospirosis_and_scrub_typhus_ L2 - http://aac.asm.org/cgi/pmidlookup?view=long&amp;pmid=17638700 DB - PRIME DP - Unbound Medicine ER -