{ "schema_version": 1, "kind": "condition", "id": "endemic-typhus", "name": "Endemic Flea-Borne and Tick-Borne Typhus", "category": "infectious", "sources": "CDC Yellow Book 2024: Rickettsial Infections · CDC Yellow Book 2026: Rickettsial Diseases (NCBI Bookshelf NBK620978), Treatment · Egyptian National Drug Formulary (Antimicrobial Chapter 2023) · Egyptian National Drug Formulary - Antimicrobial 2023 (chloramphenicol monograph)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Antimicrobial 2023 · CDC Yellow Book 2026: Rickettsial Diseases (NCBI Bookshelf NBK620978), Treatment", "verified_date": "2026-08", "treatments": [ { "id": 677, "generic": "Doxycycline", "line": 1, "is_adjunct": false, "form": "oral.solid", "strength_mg": 100.0, "adult_dose": "100 mg orally twice daily", "adult_duration": "At least 5 to 7 days", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023 (doxycycline monograph): adult \"Usual dosage range: Oral: IR and most ER formulations: 100 to 200 mg/day in 1 to 2 divided doses\" with 100 mg capsules, and paediatric \"Children and Adolescents: Oral, IV: 2.2 mg/kg/dose every 12 hours, maximum dose: 100 mg/dose\". The rickettsial indication and the course length are from the CDC Yellow Book 2026 rickettsial diseases chapter (NCBI Bookshelf NBK620978), now on disk, which states: \"Doxycycline is the treatment of choice for all rickettsial infections (100 mg by mouth twice daily for a minimum of 5-7 days; or 2.2 mg/kg by mouth twice daily for children <45 kg)\".", "rationale": "Doxycycline is the definitive drug of choice for all rickettsial infections (murine typhus and tick-borne typhus) across all age groups, as short courses (< 14 days) do not cause dental staining.", "cautions": [ "In pregnancy the Yellow Book names chloramphenicol rather than azithromycin. In breastfeeding, the Egyptian formulary says a short doxycycline course is probably not harmful - so it is not an absolute bar.", "Initiate treatment immediately upon clinical suspicion of rickettsial typhus; delaying doxycycline therapy increases risk of severe organ dysfunction and mortality.", "Administer with food and plenty of water in an upright position to prevent esophageal irritation and ulceration.", "Advise patients to avoid direct sun exposure due to photosensitivity risk." ], "peds_mgkg_low": 2.2, "peds_mgkg_high": 2.2, "peds_max_mg": null, "peds_basis": "dose", "peds_unit": "mg", "peds_note": "Children < 45 kg: 2.2 mg/kg per dose orally twice daily. Children >= 45 kg: 100 mg orally twice daily. Doxycycline is first-line for rickettsial infections in children of any age.", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": [ { "weight_kg": 10, "low_mg": 22, "high_mg": 22, "capped": false }, { "weight_kg": 20, "low_mg": 44, "high_mg": 44, "capped": false }, { "weight_kg": 30, "low_mg": 66, "high_mg": 66, "capped": false }, { "weight_kg": 40, "low_mg": 88, "high_mg": 88, "capped": false } ], "brands": [ { "trade_name": "FARCODOXIN 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PHARCO", "price_egp": 11.0, "pack_count": 10, "unit_price": 1.1, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXY M.R.100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "ADWIA", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "GRANUDOXY 100MG 10 F.C. TAB.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "GLOBAL NAPI PHARMACEUTICALS > PIERRE FRANCE", "price_egp": 12.0, "pack_count": 10, "unit_price": 1.2, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXYDOX 100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EIPICO", "price_egp": 23.0, "pack_count": 10, "unit_price": 2.3, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "DOXYMYCIN 100 MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "EL NILE.", "price_egp": 30.0, "pack_count": 10, "unit_price": 3.0, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TABOCINE 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "TABUK PHARMACEUTICAL MANUFACTURING COMPANY > TABUK PHARMA", "price_egp": 46.0, "pack_count": 10, "unit_price": 4.6, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "VIBRAMYCIN 100MG 10 CAPS.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "PFIZER", "price_egp": 65.0, "pack_count": 10, "unit_price": 6.5, "strength_mg": 100.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "endemic-typhus" } ] }