1262. Clinical Characteristics and Azithromycin Efficacy in Severe Scrub Typhus of the Elderly(>65yrs)
Session: Poster Abstract Session: Travel/Tropical Medicine and Parasitology
Saturday, October 22, 2011
Room: Poster Hall B1
Background:  

There are a few studies on the clinical features and treatment for the severe scrub typhus patients. We aimed to identify the clinical features of severe scrub typhus in elderly patients who account for majority of the scrub typhus patients in Korea and to compare the efficacy of azithromycin to doxycycline.

Methods:  

This retrospective study included 288 patients over 65 years old admitted to a tertiary hospital with scrub typhus between 2000 and 2009. Clinical manifestations and outcomes were reviewed via medical records. Subjects were consisted of 129 scrub typhus patients with complications(severe cases) and 159 scrub typhus patients without complications. Severe scrub typhus patients were categorized into either the doxycycline-treated group or the azithromycin-treated group.

Results:  

Multivariate analysis demonstrated that only the following three factors were significantly associated with the severe scrub typhus: (1) WBC counts > 10, 000/mm3 (OR = 2.08, p = 0.045, CI = 1.02-4.25), (2) creatinine > 1.4 mg/dL (OR = 4.47, p = 0.000, CI = 1.94-10.28), and (3) albumin ≤ 3.0 g/dL (OR = 3.43, p = 0.001, CI = 1.71-6.89). Cure was achieved in 67 (95.7%) of 70 patients in the doxycycline-treated group and in 33 (91.7%) of 36 patients in the azithromycin-treated group. There were no statistically significant difference in the cure rate, median time to fever clearance, and duration of hospital stay between groups.

Conclusion: 

Severe scrub typhus patients over 65 years old had laboratory findings such as WBC counts > 10, 000/mm3, creatinine > 1.4 mg/dL and albumin level ≤ 3.0 g/dL. Azithromycin is not inferior to doxycycline in elderly severe scrub typhus patients.

 


Subject Category: T. Travel/tropical medicine and parasitology

Mi Ok Jang1, Seung-Ji Kang, MD2, Hee-Chang Jang, MD2, Sook In Jung, MD3 and Kyung-Hwa Park, MD3, (1)Chonnam Mational University Medical School, Gwangju, South Korea, (2)Chonnam National University Medical School, Gwangju, Korea, Republic of, (3)Chonnam national university medical school, Gwangju, Korea, Republic of

Disclosures:

M. O. Jang, None

S. J. Kang, None

H. C. Jang, None

S. I. Jung, None

K. H. Park, None

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