Chanta 2015.

Methods	RCT Duration: 2 years, 11 months (June 2010 to May 2013) Adverse event monitoring: patient report
Participants	Children with positive scrub typhus RDT Number randomized: 57 Inclusion criteria: hospitalized children ≤ 15 years of age; clinical manifestations compatible with scrub typhus; confirmatory laboratory tests Exclusion criteria: allergy to study drug; severe clinical complications (hypotension, coma, respiratory failure, acute renal failure with renal replacement therapy); anti‐microbial therapy < 7 days pre‐admission Laboratory diagnosis: dipstick RDT (SD Bioline Tsutsugamushi test)
Interventions	Azithromycin: oral sachets 20 mg/kg/dose initially, maximum 1000 mg first day followed by 10 mg/kg/dose, maximum 500 mg for 2 days (n = 29)* Chloramphenicol: intravenous 100 mg/kg/d 6‐hourly (n = 9; patients aged < 8 years)† Doxycycline: oral 2.2 mg/kg/dose (maximum 100 mg/dose) 12‐hourly day 1; same dose once daily for at least 5 days or until defervescence (3 days; n = 19)† *Changed to "standard treatment" if clinical failure †Children under 8 received chloramphenicol; children 8 and older received doxycycline
Outcomes	Cure, defined as defervescence* within 72 hours Failure, defined as persistence of fever > 72 hours or complications Time to defervescence* Relapse (within 30 days) Adverse events *Temperature < 37.3°C maintained for > 48 hours
Notes	Country: Thailand Setting: tertiary hospital, paediatrics unit Funding: Chiangrai Prachanukroh Hospital fund Follow‐up: 1 month after discharge
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Computer‐generated randomization; no further details
Allocation concealment (selection bias)	Unclear risk	No details reported
Blinding (performance bias and detection bias) All outcomes	High risk	"Open‐label"; no further details
Incomplete outcome data (attrition bias) All outcomes	Low risk	57 randomized after RDT positive diagnosis. No missing data (57/57)
Selective reporting (reporting bias)	Low risk	All prespecified outcomes adequately reported. Adverse events defined as those "related to the administration of the antibiotic"
Other bias	Low risk	No obvious other sources of bias