Antibiotics in the treatment of scrub typhus: A network meta-analysis and cost-effectiveness analysis

Introduction: A pharmacoeconomic analysis model was developed to evaluate the cost-effectiveness of antibiotics from a societal perspective in Korea and China. A network meta-analysis was conducted to evaluate the efficacy of antibiotics. Methodology: We conducted a systematic search for randomiz...

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Main Authors: Chaoxin Chen, Tingting Chen, Dan Xue, Maobai Liu, Bin Zheng
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2025-01-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/19228
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author Chaoxin Chen
Tingting Chen
Dan Xue
Maobai Liu
Bin Zheng
author_facet Chaoxin Chen
Tingting Chen
Dan Xue
Maobai Liu
Bin Zheng
author_sort Chaoxin Chen
collection DOAJ
description Introduction: A pharmacoeconomic analysis model was developed to evaluate the cost-effectiveness of antibiotics from a societal perspective in Korea and China. A network meta-analysis was conducted to evaluate the efficacy of antibiotics. Methodology: We conducted a systematic search for randomized controlled trials or quasi-randomized controlled trials on antibiotics employed as therapy in scrub typhus management. We performed a network meta-analysis to obtain their relative efficacy. The outcome measures for efficacy were cure rate and non-relapse rate. To evaluate their relative cost-effectiveness in Korea and China, a decision analytic model simulating a cohort of scrub typhus patients using antibiotics as therapy was constructed from a societal perspective over 8 weeks. The number of cure cases per 1000 patients and the incremental cost-effectiveness ratio (ICER) was calculated. Results: We identified 11 relevant articles for network meta-analysis. Of the seven comparisons (azithromycin, chloramphenicol, doxycycline, high-dose rifampin, low-dose rifampin, telithromycin, tetracycline) included in the network meta-analysis, tetracycline was the most effective drug for the treatment of scrub typhus, but the difference is not significant. In the cost-effectiveness analysis, all the treatments were dominated by tetracycline in Korea and China. Conclusions: Tetracycline is the most economic drug for the treatment of scrub typhus. Hence, tetracycline is recommended as the first choice for the treatment of scrub typhus without contraindications in China and Korea.
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spelling doaj-art-ace72eb82a04499ab63412ddbc3cbc4f2025-08-20T02:57:17ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802025-01-01190110.3855/jidc.19228Antibiotics in the treatment of scrub typhus: A network meta-analysis and cost-effectiveness analysisChaoxin Chen0Tingting Chen1Dan Xue2Maobai Liu3Bin Zheng4Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Pharmacy, Fujian Obstetrics and Gynecology Hospital, Fuzhou, ChinaDepartment of Respiratory, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, ChinaDepartment of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China Introduction: A pharmacoeconomic analysis model was developed to evaluate the cost-effectiveness of antibiotics from a societal perspective in Korea and China. A network meta-analysis was conducted to evaluate the efficacy of antibiotics. Methodology: We conducted a systematic search for randomized controlled trials or quasi-randomized controlled trials on antibiotics employed as therapy in scrub typhus management. We performed a network meta-analysis to obtain their relative efficacy. The outcome measures for efficacy were cure rate and non-relapse rate. To evaluate their relative cost-effectiveness in Korea and China, a decision analytic model simulating a cohort of scrub typhus patients using antibiotics as therapy was constructed from a societal perspective over 8 weeks. The number of cure cases per 1000 patients and the incremental cost-effectiveness ratio (ICER) was calculated. Results: We identified 11 relevant articles for network meta-analysis. Of the seven comparisons (azithromycin, chloramphenicol, doxycycline, high-dose rifampin, low-dose rifampin, telithromycin, tetracycline) included in the network meta-analysis, tetracycline was the most effective drug for the treatment of scrub typhus, but the difference is not significant. In the cost-effectiveness analysis, all the treatments were dominated by tetracycline in Korea and China. Conclusions: Tetracycline is the most economic drug for the treatment of scrub typhus. Hence, tetracycline is recommended as the first choice for the treatment of scrub typhus without contraindications in China and Korea. https://jidc.org/index.php/journal/article/view/19228Scrub typhusnetwork meta-analysiscost-effectiveness analysisdecision analytic modelantibiotics
spellingShingle Chaoxin Chen
Tingting Chen
Dan Xue
Maobai Liu
Bin Zheng
Antibiotics in the treatment of scrub typhus: A network meta-analysis and cost-effectiveness analysis
Journal of Infection in Developing Countries
Scrub typhus
network meta-analysis
cost-effectiveness analysis
decision analytic model
antibiotics
title Antibiotics in the treatment of scrub typhus: A network meta-analysis and cost-effectiveness analysis
title_full Antibiotics in the treatment of scrub typhus: A network meta-analysis and cost-effectiveness analysis
title_fullStr Antibiotics in the treatment of scrub typhus: A network meta-analysis and cost-effectiveness analysis
title_full_unstemmed Antibiotics in the treatment of scrub typhus: A network meta-analysis and cost-effectiveness analysis
title_short Antibiotics in the treatment of scrub typhus: A network meta-analysis and cost-effectiveness analysis
title_sort antibiotics in the treatment of scrub typhus a network meta analysis and cost effectiveness analysis
topic Scrub typhus
network meta-analysis
cost-effectiveness analysis
decision analytic model
antibiotics
url https://jidc.org/index.php/journal/article/view/19228
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AT tingtingchen antibioticsinthetreatmentofscrubtyphusanetworkmetaanalysisandcosteffectivenessanalysis
AT danxue antibioticsinthetreatmentofscrubtyphusanetworkmetaanalysisandcosteffectivenessanalysis
AT maobailiu antibioticsinthetreatmentofscrubtyphusanetworkmetaanalysisandcosteffectivenessanalysis
AT binzheng antibioticsinthetreatmentofscrubtyphusanetworkmetaanalysisandcosteffectivenessanalysis