Rajapakse Senaka, Rodrigo Chaturaka, Fernando Sumadhya Deepika
Department of Clinical Medicine, Faculty of Medicine, University of Colombo, 25 Kynsey Road, Colombo 08, Sri Lanka.
Trop Doct. 2011 Jan;41(1):1-4. doi: 10.1258/td.2010.100311.
Scrub typhus is a vector-borne disease caused by the pathogen Orientia tsutsugamushi. We review the published literature for evidence on drug treatment in scrub typhus. Doxycycline has a proven efficacy in several trials and a meta-analysis, although resistance has been documented in parts of northern Thailand. Macrolides are equally efficacious and have less adverse effects, but they are expensive. Azithromycin is the recommended drug in pregnancy and for children. Rifampicin is effective in areas where doxycycline resistance is present. Quinolones have shown some degree of efficacy but the evidence is scant. Most clinical evidence on drug treatment is from cases of mild-to-moderate scrub typhus. Further study is needed on the efficacy of different antibiotics in the treatment of severe, life-threatening scrub typhus.
恙虫病是由恙虫病东方体病原体引起的一种媒介传播疾病。我们查阅已发表的文献以获取恙虫病药物治疗的证据。多西环素在多项试验和一项荟萃分析中已证实有效，尽管在泰国北部部分地区已记录到耐药情况。大环内酯类药物同样有效且不良反应较少，但价格昂贵。阿奇霉素是孕期和儿童的推荐用药。利福平在存在多西环素耐药的地区有效。喹诺酮类药物已显示出一定程度的疗效，但证据不足。关于药物治疗的大多数临床证据来自轻至中度恙虫病病例。需要进一步研究不同抗生素在治疗严重的、危及生命的恙虫病方面的疗效。
