Korean J Pediatr Infect Dis.  2002 Nov;9(2):175-181. 10.14776/kjpid.2002.9.2.175.

Clarithromycin Therapy for Scrub Typus

• Kim S
• Jung EM
• Moon KH
• Yoe SY
• Eum SJ
• Lee JH
• Jo SR
• Ma SH

• KMID: 2440110
• DOI: http://doi.org/10.14776/kjpid.2002.9.2.175

Abstract

PURPOSE
Scrub typhus(tsutsugamushi disease) is a febrile disease characterized by fever, rash, eschar, lymphadenopathy. Therapy with tetracycline(doxycycline) or chloramphenicol is currently recommended for the treatment for scrub typhus. But there are limitations in usage a tetracycline(doxycycline) for scrub typhus in the children. Recently, there was a report that azithromycin, a macrolide antibiotic was used for scrub typhus in pregnant woman successfully. So we evaluated the effectiveness of the Clarithromycin, other a macrolide antibiotic, for scrub typhus.
METHODS
Seven patients with scrub typhus at department of internal medicine and three patients with scrub typhus at department of pediatrics Masan Fatima Hospital were involved for this study. A serologic diagnosis for scrub typhus were performed by use of passive hemagglutination test. Clarithromycin(Abbott Laboratories, North Chicago, IL, USA) was administrated orally in a daily dose of 500 mg for adult patients and 15 mg/kg/bid/day for pediatric patients.
RESULTS
There were 7 cases of adult patients, varying from 28 to 76 years of age and 3 cases of pediatirc patients, varying from 4 to 7 years of age with scrub typhus. All of cases had fever, myalgia, headache, rash, eschar. Seven cases had positive passive hemagglutination test and eight cases had abnormal liver function. Mean duration for the removal of fever after medication was 1.3 day(1~2 days) and all cases were recovered without complications.
CONCLUSION
Our results suggest that Clarithromycin therapy may be effective for scrub typhus.

Keyword

Clarithromycin; Scrub typhus

MeSH Terms

Adult
Azithromycin
Child
Chloramphenicol
Clarithromycin*
Diagnosis
Exanthema
Female
Fever
Headache
Hemagglutination Tests
Humans
Internal Medicine
Liver
Lymphatic Diseases
Myalgia
Pediatrics
Pregnant Women
Scrub Typhus
Azithromycin
Chloramphenicol
Clarithromycin