This version first published online:
April 24. 2000
Last assessed as up-to-date:
August 24. 2004
Abstract
Background
Scrub typhus is a bacterial disease in regions of Asia and the Pacific. Antibiotics (chloramphenicol, tetracycline, and doxycycline) have been used to treat the disease. Resistance to these antibiotics has been reported.
Objectives
To evaluate antibiotic regimens for treating scrub typhus.
Search strategy
We searched the Cochrane Infectious Diseases Group specialized trials register (August 2004); CENTRAL (The Cochrane Library, Issue 3, 2004); MEDLINE (1966 to August 2004); EMBASE (1988 to August 2004); and LILACS (August 2004). We checked references and contacted authors for additional data.
Selection criteria
Randomized and quasi-randomized studies comparing antibiotic regimens in people diagnosed with scrub typhus.
Data collection and analysis
One reviewer screened the search results; both reviewers assessed eligibility, quality and extracted data. We used Review Manager (Version 4.1), and expressed results as Risk Ratio (binary) or mean difference (continuous), with 95% confidence intervals.
Main results
Four trials involving 451 adults met the inclusion criteria. One small study did not demonstrate a difference between tetracycline with chloramphenicol (participants afebrile after 48 hours, Risk Ratio 1.00; 95% confidence interval 0.07 to 15.26). Two small trials did not show a difference between doxycycline and tetracycline (participants afebrile after 48 hours, Risk Ratio 0.46; 95% confidence interval 0.12 to 1.75). One trial showed rifampicin to be more effective than doxycycline (for eliminating fever, Risk Ratio 0.41; 95% confidence interval 0.22 to 0.77; no relapses in either group).
Authors' conclusions
Limited data has not demonstrated a difference between tetracycline and doxycycline. Limited data suggest rifampicin is effective in areas where scrub typhus appears to respond poorly to standard anti-rickettsial drugs. .