title: Intravenous minocycline versus oral doxycycline for the treatment of noncomplicated scrub typhus.
abstract: BACKGROUND
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Both antibiotics have similar efficacy for the treatment of noncomplicated scrub typhus. Nearly all cases responding to both antibiotics became afebrile within 3 days.
authors.affiliation: Section of Infectious Disease, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan. antibody_1@msn.com
authors.forename: Chen-Chi
authors.initials: CC
authors.lastname: Tsai
authors.affiliation: Section of Infectious Disease, Department of Medicine, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan.
authors.forename: Chorng-Jang
authors.initials: CJ
authors.lastname: Lay
authors.affiliation: College of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: Yu-Huai
authors.initials: YH
authors.lastname: Ho
authors.affiliation: College of Medicine, Tzu Chi University, Hualien, Taiwan; Section of Infectious Disease, Department of Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors.forename: Lih-Shinn
authors.initials: LS
authors.lastname: Wang
authors.affiliation: College of Medicine, Tzu Chi University, Hualien, Taiwan; Department of Emergency Medicine, Tzu Chi General Hospital, Hualien, Taiwan.
authors.forename: Li-Kuang
authors.initials: LK
authors.lastname: Chen
mesh_terms: D061605:Administration, Intravenous; D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004318:Doxycycline / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000008:administration & dosage*; D012189:Retrospective Studies; D012612:Scrub Typhus / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D008911:Minocycline; D004318:Doxycycline