Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

Typhus Medication

  • Author: Jason F Okulicz, MD, FACP, FIDSA; Chief Editor: Michael Stuart Bronze, MD  more...
 
Updated: Apr 06, 2015
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity, to prevent complications, and to eradicate infection.

Next

Antibiotics

Class Summary

Specific antimicrobial therapy effective against rickettsia should be used. Doxycycline and chloramphenicol are used as antirickettsial agents for the treatment of typhus.

In Thailand, the emergence of doxycycline-resistant scrub typhus has caused clinicians to seek alternative antimicrobials.[12] Azithromycin and rifampicin have been shown to be effective in small trials conducted in areas with known doxycycline resistance.[13]

Doxycycline (Doryx, Bio-Tab, Vibramycin)

 

Inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria. No dose adjustment is necessary in renal impairment.

Chloramphenicol (Chloromycetin)

 

Generally bacteriostatic to most susceptible microorganisms; binds to the 50S bacterial ribosomal subunits and inhibits bacterial growth by inhibiting protein synthesis. Not preferred therapy for treating patients with typhus.

Previous
 
 
Contributor Information and Disclosures
Author

Jason F Okulicz, MD, FACP, FIDSA Director, HIV Medical Evaluation Unit, Infectious Disease Service, San Antonio Military Medical Center; Associate Professor of Medicine, F Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences; Clinical Associate Professor of Medicine, University of Texas Health Science Center at San Antonio; Adjunct Clinical Instructor, Feik School of Pharmacy, University of the Incarnate Word

Jason F Okulicz, MD, FACP, FIDSA is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Coauthor(s)

Burke A Cunha, MD Professor of Medicine, State University of New York School of Medicine at Stony Brook; Chief, Infectious Disease Division, Winthrop-University Hospital

Burke A Cunha, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Mark S Rasnake, MD, FACP Assistant Professor of Medicine, Program Director, Internal Medicine Residency, University of Tennessee Graduate School of Medicine; Consulting Staff, Department of Infectious Diseases, University of Tennessee Medical Center at Knoxville

Mark S Rasnake, MD, FACP is a member of the following medical societies: American Association for the Advancement of Science, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Thomas M Kerkering, MD Chief of Infectious Diseases, Virginia Tech Carilion School of Medicine

Thomas M Kerkering, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American Public Health Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Medical Society of Virginia, Wilderness Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Michael Stuart Bronze, MD David Ross Boyd Professor and Chairman, Department of Medicine, Stewart G Wolf Endowed Chair in Internal Medicine, Department of Medicine, University of Oklahoma Health Science Center; Master of the American College of Physicians; Fellow, Infectious Diseases Society of America

Michael Stuart Bronze, MD is a member of the following medical societies: Alpha Omega Alpha, American Medical Association, Oklahoma State Medical Association, Southern Society for Clinical Investigation, Association of Professors of Medicine, American College of Physicians, Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Additional Contributors

John M Leedom, MD Professor Emeritus of Medicine, Keck School of Medicine of the University of Southern California

John M Leedom, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Society for Microbiology, Infectious Diseases Society of America, International AIDS Society, Phi Beta Kappa

Disclosure: Nothing to disclose.

Acknowledgements

Eric A Hansen, DO Fellow, Clinical Instructor, Department of Internal Medicine, Division of Infectious Diseases, Winthrop-University Hospital, State University of New York at Stony Brook

Eric A Hansen, DO is a member of the following medical societies: American Medical Association, American Osteopathic Association, Infectious Diseases Society of America, and Undersea and Hyperbaric Medical Society

Disclosure: Nothing to disclose.

References
  1. Chapman AS, Swerdlow DL, Dato VM, Anderson AD, Moodie CE, Marriott C, et al. Cluster of sylvatic epidemic typhus cases associated with flying squirrels, 2004-2006. Emerg Infect Dis. 2009 Jul. 15(7):1005-11. [Medline]. [Full Text].

  2. Reynolds MG, Krebs JS, Comer JA, et al. Flying squirrel-associated typhus, United States. Emerg Infect Dis. 2003 Oct. 9(10):1341-3. [Medline].

  3. Boostrom A, Beier MS, Macaluso JA, et al. Geographic association of Rickettsia felis-infected opossums with human murine typhus, Texas. Emerg Infect Dis. 2002 Jun. 8(6):549-54. [Medline].

  4. Blanton LS, Vohra RF, Bouyer DH, Walker DH. Reemergence of murine typhus in Galveston, Texas, USA, 2013. Emerg Infect Dis. 2015 Mar. 21(3):484-6. [Medline]. [Full Text].

  5. Civen R, Ngo V. Murine typhus: an unrecognized suburban vectorborne disease. Clin Infect Dis. 2008 Mar 15. 46(6):913-8. [Medline].

  6. Badiaga S, Benkouiten S, Hajji H, Raoult D, Brouqui P. Murine typhus in the homeless. Comp Immunol Microbiol Infect Dis. 2011 Nov 15. [Medline].

  7. Saah AJ. Orientia tsutsugamushi (Scrub typhus). Principles and Practice of Infectious Diseases. 2000. 2056-2057.

  8. Jensenius M, Han PV, Schlagenhauf P, Schwartz E, Parola P, Castelli F, et al. Acute and Potentially Life-Threatening Tropical Diseases in Western Travelers--A GeoSentinel Multicenter Study, 1996-2011. Am J Trop Med Hyg. 2013 Feb. 88(2):397-404. [Medline].

  9. Giulieri S, Jaton K, Cometta A, Trellu LT, Greub G. Development of a duplex real-time PCR for the detection of Rickettsia spp. and typhus group rickettsia in clinical samples. FEMS Immunol Med Microbiol. 2011 Nov 21. [Medline].

  10. Wongchotigul V, Waicharoen S, Riengrod S, et al. Development and evaluation of a latex agglutination test for the rapid diagnosis of scrub typhus. Southeast Asian J Trop Med Public Health. 2005 Jan. 36(1):108-12. [Medline].

  11. Chen HC, Chang HC, Chang YC, Liu SF, Su MC, Huang KT, et al. Chest radiographic presentation in patients with scrub typhus. Trans R Soc Trop Med Hyg. 2011 Oct 25. [Medline].

  12. Watt G, Kantipong P, Jongsakul K, et al. Doxycycline and rifampicin for mild scrub-typhus infections in northern Thailand: a randomised trial. Lancet. 2000 Sep 23. 356(9235):1057-61. [Medline].

  13. Kim YS, Yun HJ, Shim SK, et al. A comparative trial of a single dose of azithromycin versus doxycycline for the treatment of mild scrub typhus. Clin Infect Dis. 2004 Nov 1. 39(9):1329-35. [Medline].

  14. Christie AB. Rickettsial disease: typhus. Infectious Diseases: Epidemiology and Clinical Practice. 1987. 2: 1070-1097.

  15. Dumler JS, Walker DH. Rickettsia typhi (Murine typhus). Principles and Practice of Infectious Diseases. 2000. 2053-55.

  16. Fergie JE, Purcell K, Wanat D. Murine typhus in South Texas children. Pediatr Infect Dis J. 2000 Jun. 19(6):535-8. [Medline].

  17. Higgins JA, Azad AF. Murine flea-borne typhus. Hunter GW, Thomas SG, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 8th ed. Philadelphia, Pa: WB Saunders and Co; 2000. 434-5.

  18. La Scola B, Raoult D. Laboratory diagnosis of rickettsioses: current approaches to diagnosis of old and new rickettsial diseases. J Clin Microbiol. 1997 Nov. 35(11):2715-27. [Medline].

  19. Olson JG. Typhus: general principles. Hunter GW, Thomas SG, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 8th ed. Philadelphia, Pa: WB Saunders and Co; 2000. 430-3.

  20. Raoult D, Roux V. Rickettsioses as paradigms of new or emerging infectious diseases. Clin Microbiol Rev. 1997 Oct. 10(4):694-719. [Medline].

  21. Saah AJ. Rickettsia prowazekii (epidemic or louse-borne typhus). Principles and Practice of Infectious Diseases. 2000. 2050-2053.

  22. Watt G, Olson JG. Scrub typhus. Hunter GW, Thomas SG, eds. Hunter's Tropical Medicine and Emerging Infectious Diseases. 8th ed. Philadelphia, Pa: WB Saunders and Co; 2000. 443-5.

  23. Watt G, Parola P. Scrub typhus and tropical rickettsioses. Curr Opin Infect Dis. 2003 Oct. 16(5):429-36. [Medline].

 
Previous
Next
 
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.