Abstract Scrub typhus is a major cause of acute undifferentiated fever in children in endemic regions. Although azithromycin is used as an alternative to doxycycline, variable clinical response has been observed. We present a case series of 76 pediatric scrub typhus patients initially treated with azithromycin. Sixteen patients responded after extended therapy, whereas nine required switching to doxycycline due to persistent fever. All patients treated with doxycycline became afebrile rapidly. This case series highlights the possibility of delayed or inadequate response to azithromycin.
Mohanta et al. (Thu,) studied this question.