We have conducted the largest ever clinical treatment trials of scrub typhus and murine typhus to date in Thailand and Laos. These studies have been evaluating the antibiotic treatment response to Doxycycline and Azithromycin in patients with scrub typhus and murine typhus acquired in Udon Thani and in Laos.
Future antibiotic treatment trials will expand geographically to include South India and Northern Thailand (areas of potential antibiotic resistance) in typhus patients randomized to receive various treatment regimes. Studies are stratified to investigate aspects of severe disease and complications, optimal treatment dosing, disease severity scoring and dosage evaluations based on pharmacometrics.
There is a paucity of published reports on pregnancy outcome following scrub and murine typhus despite these infections being leading causes of undifferentiated fever in Asia. Recent fever-in-pregnancy studies at SMRU (Thai-Myanmar border) have highlighted the importance of rickettsial illnesses in this patient group and their devastating effects in pregnancy, associated to high proportions of miscarriage and poor neonatal outcomes.