Contact information
Type
Scientific
Primary contact
Dr Paul Newton
ORCID ID
Contact details
Microbiology laboratory
Ministry of Health
Mahosot Hospital
Mahosot Road
Vientiane
-
Laos
+856 (0)21 250752
paul@tropmedres.ac
Additional identifiers
EudraCT number
ClinicalTrials.gov number
Protocol/serial number
066828
Study information
Scientific title
An open, randomised clinical trial of three days oral doxycycline versus seven days oral doxycycline versus three days oral azithromycin in the treatment of Scrub and Murine Typhus
Acronym
MUT and SUT
Study hypothesis
That fever clearance times and the frequencies of relapse and treatment failure do not differ between three days oral doxycycline versus seven days oral doxycycline versus three days oral azithromycin in the treatment of scrub and murine typhus.
Ethics approval
1. Oxford Tropical Ethics Committee (OXTREC), 27/03/2003, ref: OXTREC 003-03
2. Faculty of Medical Sciences, Vientiane, Laos Ethical Committee, 03/06/2003, ref: FMS 3-6-2003
Study design
Randomised controlled trial
Primary study design
Interventional
Secondary study design
Randomised controlled trial
Trial setting
Hospitals
Trial type
Treatment
Patient information sheet
Not available in web format, please use the contact details to request a patient information sheet
Condition
Scrub typhus, murine typhus
Intervention
An open, randomised comparative trial of three days oral doxycycline versus seven days oral doxycycline versus three days oral azithromycin.
Added 02/02/2009:
Each of the two diseases have the same three treatment arms:
1. Oral doxycycline 100 mg every 12 hours for 7 days (after a 200 mg loading dose)
2. Doxycycline 100 mg every 12 hours for 3 days (after a 200 mg loading dose)
3. Oral azithromycin 500 mg on day 1 and then 250 mg every 24 hours for 2 more days
Follow up is for one year.
Intervention type
Drug
Phase
Not Applicable
Drug names
Doxycycline, azithromycin
Primary outcome measure
Current information as of 02/02/2009:
Fever clearance time and area under the fever-time curve during inpatient stay.
Initial information at time of registration:
1. Fever clearance times
2. Frequencies of treatment failure
3. Frequencies of relapse
Secondary outcome measures
Added as of 02/02/2009:
1. Treatment failure frequency
2. Relapse frequency
Overall trial start date
04/08/2003
Overall trial end date
31/12/2009
Reason abandoned (if study stopped)
Eligibility
Participant inclusion criteria
Current information as of 02/02/2009:
1. Adult (greater than 15 years) non-pregnant patients with suspected typhus. Suspected typhus will be defined as undifferentiated fever (aural temperature greater than 37.5°C), with or without an eschar, with a positive scrub typhus Lateral Flow IgM result or a murine typhus IgM Dip-S-Ticks result
2. Written informed consent to the study
3. Able to stay in hospital for the duration of the treatment (up to 7 days) and high likelihood of completing at least 4 weeks follow up
4. Able to take oral medication
5. A negative urinary pregnancy test for all women of child bearing age
6. None of the exclusion criteria
Initial information at time of registration:
1. Adult (more than or equal to 15 years, either sex) non-pregnant patients with suspected typhus, with a positive scrub typhus Lateral Flow result or a murine typhus Dip-S-Ticks result
2. Written informed consent
3. Able to stay in hospital for the duration of the treatment
4. High likelihood of completing at least four weeks follow up
5. Able to take oral medication
6. A negative urinary pregnancy test for all women of childbearing age
7. None of the exclusion criteria
Participant type
Patient
Age group
Adult
Gender
Both
Target number of participants
71 patients in each arm for each disease (total: 213 for each disease) (added 02/02/2009)
Participant exclusion criteria
Current information as of 02/02/2009:
1. Known hypersensitivity to tetracycline, doxycycline or azithromycin
2. Administration of chloramphenicol, doxycycline, tetracycline, fluoroquinolones or azithromycin during the preceeding week
3. Pregnancy or breastfeeding
4. Contraindications to doxycycline: severe hepatic impairment, known systemic lupus erythematosus (SLE)
5. Contraindications to azithromycin: severe hepatic impairment
6. Severe typhus defined as:
6.1. Reduced level of consciousness
6.2. Clinical jaundice
6.3. Shock (blood pressure [BP] systolic less than 80 mmHg)
6.4. Vomiting sufficient to disallow the use of oral medication
6.5. Clinical or radiological evidence for lung involvement
6.6. Clinical evidence for meningitis/encephalitis or the need for a lumbar puncture (LP)
6.7. Any other syndrome which in the opinion of the admitting doctor constitutes severe typhus (reason must be stated)
Initial information at time of registration:
1. Known hypersensitivity to tetracycline, doxycycline or azithromycin
2. Administration of chloramphenicol, doxycycline, tetracycline, fluoroquinolones or azithromycin during the preceeding week
3. Pregnancy or breast feeding
4. Contraindications to doxycycline or azithromycin and severe typhus
Recruitment start date
04/08/2003
Recruitment end date
31/12/2009
Locations
Countries of recruitment
Laos
Trial participating centre
Mahosot Hospital
Vientiane
-
Laos
Sponsor information
Organisation
University of Oxford (UK)
Sponsor details
Churchill Hospital
CCVTM
Headington
Oxford
OX3 7LJ
United Kingdom
Sponsor type
University/education
Website
Funders
Funder type
Charity
Funder name
Wellcome Trust (grant ref: 066828)
Alternative name(s)
Wellcome
Funding Body Type
private sector organisation
Funding Body Subtype
international
Location
United Kingdom
Results and Publications
Publication and dissemination plan
Not provided at time of registration
Intention to publish date
Participant level data
Not provided at time of registration
Basic results (scientific)
Publication list
2018 results in: https://www.ncbi.nlm.nih.gov/pubmed/30020447