Multi-institute research team identifies better drug treatment for severe scrub typhus

Researchers from PGMIER Chandigarh, IGMC Shimla, JIPMER Puducherry, Christian Medical College, Vellore, etc. were part of this research study.

Research team. (Picture: Press Release)Research team. (Picture: Press Release)

Ishita Ranganath | March 2, 2023 | 02:46 PM IST

NEW DELHI: A multi-institute research team have identified a new drug combination for the treatment for severe scrub typhus. The research study found that a combination anti-biotic treatment is more affective for treating the infection than sing-drug therapies.

The research study was published in the journal, The New England Journal of Medicine. The collaborating institutes included Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, Indira Gandhi Medical College & Hospital (IGMC) Shimla, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Jawaharlal Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, Christian Medical College, Vellore, SVIMS Tirupati and KMC Manipal.

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A infectious diseases physician from Christian Medical College, Vellore, M Varghese and the INTREST trial investigators conducted a multi-centric randomised controlled trial funded by the DBT/Welcome India Alliance to identify the best treatment option for patients with severe scrub typhus. This showed that treatment with intravenous doxycycline and azithromycin is more effective than using either drug on its own.

The trial found that combination therapy was better than therapy with intravenous doxycycline or azithromycin alone. Patients who were treated with combination antibiotics had fewer complications from the infection on day 7. The study also showed, that in line with other studies there was no difference in the outcome between using doxycycline or azithromycin alone.

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Explaining the significance of this research, Christian Medical College, Vellore, department of infectious diseases, M Varghese, said: “The implication of this study is that when using a combination of azithromycin and doxycycline to treat severe scrub typhus, more patients can be discharged from the hospital by day 7 as they would have fewer persisting complications, such as respiratory distress syndrome (ARDS), hepatitis, hypotension/shock, meningoencephalitis, and kidney failure. This trial provides evidence that combination therapy with intravenous doxycycline and azithromycin is a better therapeutic option for the treatment of severe scrub typhus than monotherapies of either drug. This new evidence will change treatment guidelines and save the lives of thousands of people with scrub typhus in the future.”

Highlighting the need for such research, M Varghese added, “Scrub typhus typically presents as a fever that may be associated with headaches, coughs, shortness of breath, and brain symptoms, like confusion and disorientation. About six per cent of patients infected with scrub typhus could die in spite of diagnosis and treatment. One-third of patients develop severe disease that affects multiple organs in the body and leads to lethally low blood pressure. Death rates in severe disease can reach up to 70 per cent without treatment and 24 per cent with treatment.”

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