Assessment of outcome of oral doxycycline versus intravenous doxycycline for the treatment of uncomplicated scrub typhus in children at a tertiary care centre

Abstract

Background: Scrub typhus is an acute febrile sickness caused by the bacterium Orientia tsutsugamushi. The present study was conducted to assess outcome of oral doxycycline versus intravenous doxycycline for the treatment of uncomplicated scrub typhus in children. Materials & Methods: 80 children less than 15 years of age with typhus fever of both genders were divided into 2 groups of 40 each. Group I received oral doxycycline and group II received iv doxycycline. Parameters such as mean duration of symptoms before starting doxycycline, mean time of starting doxycycline after admission, clinical features and outcome were recorded. 
Results: The mean duration of symptoms before starting doxycycline was 4.7 days in group I and 6.3 days in group II. The mean time of starting doxycycline after admission was 2.3 days in group I and 2.9 days in group II. The difference was significant (P< 0.05). Clinical features were eschar in 14 and 15, fever in 17 and 21, headache in 11 and 13, peripheral oedema in 13 and 20, hepatomegaly in 12 and 18 and splenomegaly in 9 and 10 patients in group I and group II respectively. The difference was significant (P< 0.05). The mean fever defervescence in group I was 29.5 hours and in group II was 28.1 hours. The incidence of delayed defervescence (>48 hours) was seen in 14 in group I and 7 in group II. The difference was significant (P< 0.05).