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KMID : 0351219950270020193
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Korean Journal of Infectious Diseases
1995 Volume.27 No. 2 p.193 ~ p.198
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an Open Clinical Trial to Compare the Efficacy of Ciprofloxacin, Pefloxacin, and Doxycycline in the Treatment of Scrub Typhus
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오수용
정문현/오세진/손민수/안승운
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Abstract
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Background:
@EN Although doxyeyline is the antimicrobial drug of choice for the treatment of scrub typhus, it has no role in the treatment of typhoid fever. typhoid fever and rickettsial infections are similar in many clinical features. For the empirical
treatment
of suspected rickettsial infections in areas where typhoid fever and rickettsial infections are endemic, it is preferable to use an agent which has an additional antimicrobial activity against salmonella species. Fluoroquinolones are effective
against
typhoid fever, and recent studies revealed that quinolones might be effective against several rickettsial infections.
@ES Methods:
@EN We conducted an open clinical study of patients with scrub typhus who were admitted to the Chungang Gil hospital during the period from 1992 through 1994. Patients were assigned to ciprofloxacin (200mg intravenously every 12 hours),
pefloxacin
(400mg every 12 hours), or doxycycline (100mg every 12 hours). IF no clinical improvement was achieved within 6 doses of medications, we defined it as treatment failure.
@ES Results:
@EN: Of the eighteen patients, five were in the ciprofloxacin, five in the pefloxacin, and eight in the doxycycline group. there were two patients of treatment failure, one (20%) in the ciprofloxacin and one (20%) in the pefloxacin group. there
was
no
case of treatment failure in the doxycycline group. Doses, administered t the remaining patients until defervescence, were 3, 6, 7, 9 (median 6.5) in the ciprofloxacin group; 4, 5, 3, 11 (median 6.5) in the pefloxacin group; 2, 3, 4, 4, 5, 5, 7
(median
4.0) in the doxycycline group.
@ES Conclusions:
@EN Ciprcfloxacin and pefloxacin have efficacy against scrub typhus. However, some patients were not improved clinically within 6 doses of ciprofloxacin or pefloxacin, and fluoroquinolones might show slower responses than doxycycline. Therefore,
it
would be prudent not to use ciprofloxacin or pefloxacin for the treatment of severe scrub typhus.
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