Chung Moon-Hyun, Lee Jin-Soo, Im Jae Hyoung
Korean Society of Infectious Diseases, Seoul, Korea.
Division of Infectious Diseases, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
Infect Chemother. 2023 Jun;55(2):179-184. doi: 10.3947/ic.2023.0055.
Scrub typhus can be adequately treated with doxycycline or azithromycin unless it is treated too late. Such cases present as severe scrub typhus, and their treatment remains a challenging problem. In this article, we briefly review the literature on the treatment of scrub typhus and the limitations of the combination of doxycycline and azithromycin. Several options are suggested for further study in the treatment of severe scrub typhus (such as encephalitis, myocarditis, and pneumonia), including dose escalation of doxycycline, the adjuvant use of steroids, the selective use of beta-lactam antibiotics, and the use of tigecycline.
恙虫病若治疗及时，可使用多西环素或阿奇霉素进行有效治疗。若治疗过晚，则会发展为重症恙虫病，其治疗仍是一个具有挑战性的难题。在本文中，我们简要回顾了恙虫病治疗的相关文献以及多西环素与阿奇霉素联合使用的局限性。对于重症恙虫病（如脑炎、心肌炎和肺炎）的治疗，建议进一步研究几种方案，包括增加多西环素的剂量、辅助使用类固醇、选择性使用β-内酰胺类抗生素以及使用替加环素。
