Trial reportThe New England journal of medicine2023
Intravenous Doxycycline, Azithromycin, or Both for Severe Scrub Typhus.
Open access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph
Trial report in The New England journal of medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers, 3 of them syntheses that pooled it.
0numbers the graph read from it
0cells of the map it votes in
49citing papers in PubMed, 3 pooled it
23.1field-weighted citation impact, top 1% of its field
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
49 citing papers in PubMed, 3 syntheses or guidelines pooled it, 83 citations in OpenAlex.
- Sero-Diagnosis of Scrub Typhus Infection in India: A Systematic Review and Meta-Analysis.Tropical medicine & international health : TM & IH · 2026Pooled it
- Spatiotemporal epidemiology and clinical manifestations of two decades of scrub typhus in India: a systematic review and meta-analysis.BMJ global health · 2025Pooled it
- Doxycycline vs azithromycin in patients with scrub typhus: a systematic review of literature and meta-analysis.BMC infectious diseases · 2023Pooled it
- Beyond Eschar: Unusual Skin Findings in Scrub Typhus.The American journal of tropical medicine and hygiene · 2026Article
- Tigecycline versus doxycycline for scrub typhus: a preliminary randomized trial.Tropical medicine and health · 2026Article
- Deciphering the "Doxycycline Deficiency Syndrome": Defining the Characteristic Clinical, Laboratory and Imaging Findings in Patients Presenting with Leptospirosis, Q Fever and Rickettsial Diseases in Far North Queensland, Tropical Australia.Tropical medicine and infectious disease · 2026Article
- Korat-Scrub Typhus Score: A Clinical Tool for Predicting Scrub Typhus in Patients With Acute Undifferentiated Febrile Illness.Tropical medicine & international health : TM & IH · 2026Article
- Article
- [Infection with Orientia tsutsugamushi and hospital-acquired pneumonia].Innere Medizin (Heidelberg, Germany) · 2026Article
- Cytokine and chemokine profiles linked to early severity of scrub typhus: multicenter validation of soluble PD-L1.Journal of clinical microbiology · 2026Article
- Differentiating Spotted Fever From Scrub Typhus Based on Clinical and Laboratory Features: A Retrospective Cohort Study From South India.Open forum infectious diseases · 2026Article
- Neglected rickettsial diseases in Southeast Asia: Twenty-five years of progress in surveillance, diagnostics, and clinical research.PLoS neglected tropical diseases · 2026Review
- Plasma and Intracellular Concentrations of Doxycycline and Azithromycin in Patients with Severe Scrub Typhus.Antibiotics (Basel, Switzerland) · 2026Article
- Concurrent splenic and renal infarction in scrub typhus: expanding the vasculitic spectrum.BMC infectious diseases · 2026Article
- Antibiotic Antagonism inInfection & chemotherapy · 2026Review
- Concurrent Scrub Typhus, Dengue, and Leptospirosis: A Rare Triple Co-Infection: A Case Report and Comprehensive Literature Review.Clinical case reports · 2026Article
- Cost of illness of scrub typhus in South India - a population-based, mixed-methods study.PLoS neglected tropical diseases · 2026Article
- Extracorporeal membrane oxygenation support for tropical infections: a scoping review.Journal of intensive care · 2026Review
- Evaluation of Oral Doxycycline, Azithromycin, or Sequential Doxycycline-Azithromycin Treatment for Scrub Typhus.Mediterranean journal of hematology and infectious diseases · 2026Article
- Successful management of scrub typhus-associated hemophagocytic lymphohistiocytosis with doxycycline and immunomodulation: a case report.Frontiers in pediatrics · 2026Article
Corrections and comments
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Authors and funding
35 authors at 4 institutions in 4 countries.
George M VargheseFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Divya DayanandFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).ORCID 0000-0002-8008-1810
Karthik GunasekaranFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Debasree KunduFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Mukta WyawahareFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Navneet SharmaFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Dhruva ChaudhryFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Sanjay K MahajanFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Kavitha SaravuFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Blessed W AruldhasFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Binu S MathewFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Roshini G NairFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Nalini NewbiggingFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Aswathy MathewFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Kundavaram P P AbhilashFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Manisha BiswalFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Ann H PrasadFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Anand ZachariahFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Ramya IyaduraiFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).ORCID 0000-0001-8453-6205
Samuel G HansdakFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Sowmya SathyendraFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Thambu D SudarsanamFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
John A J PrakashFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Abi ManeshFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Alladi MohanFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Joel TarningFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Stuart D BlacksellFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Pimnara PeerawaranunFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Naomi WaithiraFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Mavuto MukakaFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Phaik Yeong CheahFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
John V PeterFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Ooriapadickal C AbrahamFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
Nicholas P J DayFrom the Departments of Infectious Diseases (G.M.V., D.D., D.K., R.G.N., A.H.P., A. Manesh), Medicine (K.G., N.N., A.Z., R.I., S.G.H., S.S., T.D.S., O.C.A.), Pharmacology (B.W.A., B.S.M., A. Mathew), Emergency Medicine (K.P.P.A.), Microbiology (J.A.J.P.), and Critical Care (J.V.P.), Christian Medical College, Vellore, the Department of Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Pondicherry (M.W.), the Departments of Internal Medicine (N.S.) and Microbiology (M.B.), Post Graduate Institute of Medical Education and Research, Chandigarh, the Department of Pulmonary Care and Critical Medicine, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak (D.C.), the Department of Medicine, Indira Gandhi Medical College, Shimla (S.K.M.), the Department of Infectious Diseases, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal (K.S.), and the Department of Medicine, Sri Venkateswara Institute of Medical Sciences, Tirupati (A. Mohan) - all in India; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand (J.T., S.D.B., P.P., N.W., M.M., P.Y.C., N.P.J.D.); and the Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom (J.T., S.D.B., N.W., M.M., P.Y.C., N.P.J.D.).
INTREST Trial Investigators
Christian Medical College, Vellore · INManipal Academy of Higher Education · INPandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences · INSri Venkateswara Institute of Medical Sciences · IN
Funding
DBT-Wellcome Trust India Alliance IA/CPHS/16/1/502679Wellcome TrustWellcome Trust 220211/Z/20/Z
Abstract
backgroundThe appropriate antibiotic treatment for severe scrub typhus, a neglected but widespread reemerging zoonotic infection, is unclear.
methodsIn this multicenter, double-blind, randomized, controlled trial, we compared the efficacy of intravenous doxycycline, azithromycin, or a combination of both in treating severe scrub typhus. Patients who were 15 years of age or older with severe scrub typhus with at least one organ involvement were enrolled. The patients were assigned to receive a 7-day course of intravenous doxycycline, azithromycin, or both (combination therapy). The primary outcome was a composite of death from any cause at day 28, persistent complications at day 7, and persistent fever at day 5.
resultsAmong 794 patients (median age, 48 years) who were included in the modified intention-to-treat analysis, complications included those that were respiratory (in 62%), hepatic (in 54%), cardiovascular (in 42%), renal (in 30%), and neurologic (in 20%). The use of combination therapy resulted in a lower incidence of the composite primary outcome than the use of doxycycline (33% and 47%, respectively), for a risk difference of -13.3 percentage points (95% confidence interval [CI], -21.6 to -5.1; P = 0.002). The incidence with combination therapy was also lower than that with azithromycin (48%), for a risk difference of -14.8 percentage points (95% CI, -23.1 to -6.5; P<0.001). No significant difference was seen between the azithromycin and doxycycline groups (risk difference, 1.5 percentage points; 95% CI, -7.0 to 10.0; P = 0.73). The results in the per-protocol analysis were similar to those in the primary analysis. Adverse events and 28-day mortality were similar in the three groups.
conclusionsCombination therapy with intravenous doxycycline and azithromycin was a better therapeutic option for the treatment of severe scrub typhus than monotherapy with either drug alone. (Funded by the India Alliance and Wellcome Trust; INTREST Clinical Trials Registry-India number, CTRI/2018/08/015159.).
Indexed as
Anti-Bacterial AgentsAzithromycinDoxycyclineScrub TyphusAdministration, IntravenousAnimalsDouble-Blind MethodDrug Therapy, CombinationHumansMiddle AgedZoonosesAnti-Bacterial AgentsAzithromycinDoxycycline
Identifiers
What Socratic holds
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Registered trials
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.