3 Mar 2023 • A multi-centre clinical trial involving 800 patients found that administering a combination of antibiotic drugs is more effective than single-drug therapies for treating severe scrub typhus. The study has been published in New England Journal of Medicine.

The researchers enrolled patients who were 15 years of age or older with severe scrub typhus, and had at least one organ involved. The patients were split in three groups through a randomisation process to receive intravenous doxycycline, intravenous azithromycin, or a combination of both intravenous doxycycline and azithromycin, respectively, for a week’s duration.

What was the primary outcome?

• The trial found that combination therapy was superior to therapy with intravenous doxycycline or azithromycin alone. Patients who received combination therapy had fewer complications due to the disease on day 7
• This study also found that there was no difference in the outcome between using doxycycline or azithromycin alone
• 96 (12%) of the 800 patients died.

Together, doxycycline and azithromycin resulted in better bacterial control during the critical first week of infection. "The combination of the two drugs may have resulted in a more complete blockade of protein synthesis and consequently reduced bacterial growth and multiplication,” said Prof. George M. Varghese, Department of Infectious Diseases, CMC Vellore.

The collaborating institutions included PGIMER Chandigarh, IGMC Shimla, PGIMS Rohtak, JIPMER Puducherry, CMC Vellore & KMC Manipal.

Source: ABP | Read full story