Journal of the Korean Pediatric Society 2003;46(7):710-713.
Published online July 15, 2003.
Roxithromycin Treatment of Tsutsugamushi Disease (Scrub Typhus) in Children
Hye-Jin Park, Kyung-Yil Lee
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
소아 쯔쯔가무시병에서 록시쓰로마이신 치료
박혜진, 이경일
가톨릭대학교 의과대학 소아과학교실
Correspondence: 
Kyung-Yil Lee, Email: leekyungyil@yahoo.com
Abstract
Purpose
: Although chloramphenicol and doxycycline have been used for the treatment of tsutsugamuchi disease, a difficulty exists in determining which drugs to use in treating children because of potential complications such as aplastic anemia or teeth discoloration. We evaluated the effect of roxithromycin, a macrolide antibiotic, on tsutsugamushi disease in children.
Methods
: A retrospective analysis was conducted on 39 children with tsutsugamuchi disease(scrub typhus) who were treated with doxycycline(DC), chloramphenicol(CM), or roxythromycin(RM) between 1991 and 2000. We divided the patients into a DC-treated group(DC group; 16 children), a CM- treated group(CM group; 14 children), and RM-treated group(RM group; 9 children) and compared these groups.
Results
: Most cases(97%) developed in October and November. Fever and rash were observed in all 39 cases and an eschar was noted in 36 cases(92%). No statistical differences could be found between the three groups in mean age, duration of fever before admission, white blood cell(WBC) count, and complications including abnormal liver enzymes. In most cases defervescence after treatment was within 24 hours(34 cases, 87%), and during 24-48 hours in two cases in the DC group, one in the CM group, and two in the RM group(no statistical difference).
Conclusion
: Roxythromycin was as effective as conventional doxycycline or chloramphenicol, in children with scrub typhus and may be safer to use.
Key Words: Tsutsugamushi disease, Chloramphenicol, Doxycycline, Roxithromycin, Children


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