Tsai Chen-Chi, Lay Chorng-Jang, Ho Yu-Huai, Wang Lih-Shinn, Chen Li-Kuang
Section of Infectious Disease, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
College of Medicine, Tzu Chi University, Hualien, Taiwan.
J Microbiol Immunol Infect. 2011 Feb;44(1):33-8. doi: 10.1016/j.jmii.2011.01.007. Epub 2011 Jan 12.
Scrub typhus is an acute febrile disease for which synthetic tetracycline antibiotics are efficacious. However, no clinical studies have compared oral doxycycline with intravenous minocycline for treatment of scrub typhus.
We conducted a retrospective analysis in patients diagnosed with noncomplicated scrub typhus by serologic or molecular methods from August 2001 to July 2007. We compared the efficacy of intravenous minocycline with oral doxycycline for treatment of noncomplicated scrub typhus in these patients.
Forty seven cases receiving tetracycline antibiotics for the treatment of noncomplicated scrub typhus were included. There was no statistically significant difference for the response rate between the 25 cases receiving intravenous minocycline (96%) and the 22 cases receiving oral doxycycline (91%) (p=0.909). Kaplan-Meier curve with a long-rank test for the time to defervescence showed no statistically significant difference between minocycline therapy (mean 30 hours; range 4-124 hours) and doxycycline therapy (mean 32.4 hours; range 4-144 hours) (p=0.860). After multivariate Cox regression models, the time to defervescence was only affected by Acute Physiology and Chronic Health Evaluation II score (hazard ratio 0.868; p=0.016). Nearly all patients (93.6%) became afebrile within 72 hours after use of tetracycline antibiotics. Prolonged hospitalization (> 7 days) was correlated with the timing to start tetracycline antibiotics after admission.
Both antibiotics have similar efficacy for the treatment of noncomplicated scrub typhus. Nearly all cases responding to both antibiotics became afebrile within 3 days.
恙虫病是一种急性发热性疾病，合成四环素类抗生素对其有效。然而，尚无临床研究比较口服多西环素与静脉注射米诺环素治疗恙虫病的效果。
我们对2001年8月至2007年7月期间通过血清学或分子方法诊断为非复杂性恙虫病的患者进行了回顾性分析。比较了静脉注射米诺环素与口服多西环素治疗这些患者非复杂性恙虫病的疗效。
纳入47例接受四环素类抗生素治疗非复杂性恙虫病的病例。25例接受静脉注射米诺环素的患者的有效率为96%，22例接受口服多西环素的患者的有效率为91%，两者之间无统计学显著差异（p = 0.909）。采用对数秩检验的Kaplan-Meier曲线分析退热时间，结果显示米诺环素治疗组（平均30小时；范围4 - 124小时）与多西环素治疗组（平均32.4小时；范围4 - 144小时）之间无统计学显著差异（p = 0.860）。经过多变量Cox回归模型分析，退热时间仅受急性生理与慢性健康状况评分系统II（APACHE II）评分影响（风险比0.868；p = 0.016）。几乎所有患者（93.6%）在使用四环素类抗生素后72小时内退热。住院时间延长（> 7天）与入院后开始使用四环素类抗生素的时间相关。
两种抗生素治疗非复杂性恙虫病疗效相似。几乎所有对这两种抗生素有反应的病例在3天内退热。
