Chloromycetin in the Treatment of Scrub Typhus

Abstract

25 patients with scrub typhus were treated with chloromycetin. Diagnosis was proved in each case by recovering the causative organism from blood prior to treatment or by showing the development of agglutinins for the OX-K strain of Bacillus proteus during convalescence. Rickettsemia occurred in 20 of 25 treated patients; 24 of this group had a positive Weil-Felix reaction. All of 12 control cases gave positive Weil-Felix reactions. None of the treated patients developed complications attributable to the disease or to the drug, and none died. One treated patient was discharged nine days after the onset of symptoms. 22 of the patients were exposed in regions within a radius of 20 miles of Kuala Lumpur. 11 of the 12 untreated cases also contracted their disease in the same area. The strains which infected the treated and control groups were apparently fairly comparable in virulence. The 2 groups showed a sharp contrast in clinical response. All treated patients received an initial oral dose of 50 mg. of chloromycetin/kg. and were later given 0.2-0.3 g. of drug orally every 2.- 4 hrs. Treatment was continued for at least 12 days after onset, and these patients recived totals of 8 - 15.5 g. of drugs. The treatment time was gradually shortened, and the last 7 cases were given the drug for only 24 hrs., these patients receiving 6 g. of drug. Their responses were equally satisfactory. The drug can be used without detns. of its amt. in the blood of treated patients.