ArticleScientific reports2026
Antibiotic therapy failure and clinical outcomes in scrub typhus patients from Guangzhou city, southern China.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- A proteome-driven strategy to discover novel therapeutic targets in Orientia tsutsugamushi.Antonie van Leeuwenhoek · 2026Article
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6 authors.
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Abstract
Antibiotic therapy failure in scrub typhus (ST) has raised concerns about first-line antibiotic efficacy, necessitating reevaluation of recommended antibiotic therapies. A multicenter retrospective analysis included 2029 non-severe ST patients hospitalized in Guangzhou from 2012 to 2018. Antibiotic therapy failure was defined as needing to switch initial antibiotics due to persistent fever, clinical deterioration, or clinician-assessed need. The clinical outcomes of three antibiotic therapies were compared. Antibiotic therapy failure led to significantly greater medical needs, as evidenced by prolonged hospital stays (8 vs. 7 days, P < 0.001), longer antibiotic courses (7 vs. 5 days, P < 0.001), increased incidence of fever lasting over 5 days(19.7% [200/1821] vs. 11.0% [41/208], P < 0.001), and increased hepatic complication rates (29.8% [62/208] vs. 20.3% [370/1821], P = 0.002). Therapy failure rates varied substantially among antibiotics, being highest for chloramphenicol (32.4%, 99/306), intermediate for azithromycin (20.5%, 53/258), and lowest for doxycycline (3.8%, 56/1465). Furthermore, failure manifestations was antibiotic-specific. Azithromycin failure was associated with cardiovascular-type severe ST (RR: 3.87, P = 0.026), whereas chloramphenicol failure was correlated with hepatic-type severe ST (RR: 2.37, P = 0.008). Antibiotic therapy failure adversely affected ST outcomes with distinct, antibiotic-specific clinical patterns. Tailored monitoring and timely antibiotic switching are essential to reduce treatment failure burden and improve patient prognosis.
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