Scrub typhus, murine typhus Infections and Infestations Typhus fever
Conditions
Interventions
An open, randomised comparative trial of three days oral doxycycline versus seven days oral doxycycline versus three days oral azithromycin.
Added 02/02/2009:
Each of
Sponsors
University of Oxford (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: Current information as of 02/02/2009: 1. Adult (greater than 15 years) non-pregnant patients with suspected typhus. Suspected typhus will be defined as undifferentiated fever (aural temperature greater than 37.5°C), with or without an eschar, with a positive scrub typhus Lateral Flow IgM result or a murine typhus IgM Dip-S-Ticks result 2. Written informed consent to the study 3. Able to stay in hospital for the duration of the treatment (up to 7 days) and high likelihood of completing at least 4 weeks follow up 4. Able to take oral medication 5. A negative urinary pregnancy test for all women of child bearing age 6. None of the exclusion criteria Initial information at time of registration: 1. Adult (more than or equal to 15 years, either sex) non-pregnant patients with suspected typhus, with a positive scrub typhus Lateral Flow result or a murine typhus Dip-S-Ticks result 2. Written informed consent 3. Able to stay in hospital for the duration of the treatment 4. High likelihood of completing at least four weeks follow up 5. Able to take oral medication 6. A negative urinary pregnancy test for all women of childbearing age 7. None of the exclusion criteria
Exclusion criteria
Exclusion criteria: Current information as of 02/02/2009: 1. Known hypersensitivity to tetracycline, doxycycline or azithromycin 2. Administration of chloramphenicol, doxycycline, tetracycline, fluoroquinolones or azithromycin during the preceeding week 3. Pregnancy or breastfeeding 4. Contraindications to doxycycline: severe hepatic impairment, known systemic lupus erythematosus (SLE) 5. Contraindications to azithromycin: severe hepatic impairment 6. Severe typhus defined as: 6.1. Reduced level of consciousness 6.2. Clinical jaundice 6.3. Shock (blood pressure [BP] systolic less than 80 mmHg) 6.4. Vomiting sufficient to disallow the use of oral medication 6.5. Clinical or radiological evidence for lung involvement 6.6. Clinical evidence for meningitis/encephalitis or the need for a lumbar puncture (LP) 6.7. Any other syndrome which in the opinion of the admitting doctor constitutes severe typhus (reason must be stated) Initial information at time of registration: 1. Known hypersensitivity to tetracycline, doxycycline or azithromycin 2. Administration of chloramphenicol, doxycycline, tetracycline, fluoroquinolones or azithromycin during the preceeding week 3. Pregnancy or breast feeding 4. Contraindications to doxycycline or azithromycin and severe typhus
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Current information as of 02/02/2009: Fever clearance time and area under the fever-time curve during inpatient stay. Initial information at time of registration: 1. Fever clearance times 2. Frequencies of treatment failure 3. Frequencies of relapse | — |
Secondary
| Measure | Time frame |
|---|---|
| Added as of 02/02/2009: 1. Treatment failure frequency 2. Relapse frequency | — |
Countries
Laos
Outcome results
None listed