COMPARISON OF DOXYCYCLINE AND AZITHROMYCIN FOR THE TREATMENT OF SCRUB TYPHUS IN CHILDREN

BACKGROUND Scrub typhus is an acute, febrile, infectious illness that is caused by Orientia tsutsugamushi. Doxycycline is a best choice of initial antimicrobial treatment for scrub typhus. The other alternative drug is azithromycin. We conducted this study to compare the efficacy and adverse effects of both the drugs. METHODS This is a retrospective study done in tertiary care hospital. Study was done with aim to compare the efficacy and side effects of doxycycline and azithromycin for the treatment of scrub typhus. Cases from December 2011 to November 2015, satisfying inclusion criteria were included. The primary efficacy outcome was the time to defervescence. The secondary efficacy outcome analysed were treatment failure, relapse and adverse effects. Appropriate statistical tests were used to analyse the data. RESULTS One hundred and seven children were included in the study. There were 67 cases in the doxycycline treated group and 40 cases in the azithromycin group. Baseline characters were similar among both groups. Both antibiotic regimens were highly effective for the treatment of scrub typhus. Fever subsided early in the children who received doxycycline. There were no relapses in either group. DISCUSSION Both drugs were equally effective. Our study suggested that azithromycin was better tolerated than doxycycline. Gastrointestinal adverse events were lesser with azithromycin but statistically not significant.