↓ Skip to main content

Co-trimoxazole versus azithromycin for the treatment of undifferentiated febrile illness in Nepal: study protocol for a randomized controlled trial

Overview of attention for article published in Trials, October 2017
Altmetric Badge

About this Attention Score

  • Good Attention Score compared to outputs of the same age (69th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (59th percentile)

Mentioned by

twitter
7 tweeters

Citations

dimensions_citation
4 Dimensions

Readers on

mendeley
107 Mendeley
You are seeing a free-to-access but limited selection of the activity Altmetric has collected about this research output. Click here to find out more.
Title
Co-trimoxazole versus azithromycin for the treatment of undifferentiated febrile illness in Nepal: study protocol for a randomized controlled trial
Published in
Trials, October 2017
DOI 10.1186/s13063-017-2199-6
Pubmed ID
Authors

Sunil Pokharel, Buddha Basnyat, Amit Arjyal, Saruna Pathak Mahat, Raj Kumar KC, Abhusani Bhuju, Buddhi Poudyal, Evelyne Kestelyn, Ritu Shrestha, Dung Nguyen Thi Phuong, Rajkumar Thapa, Manan Karki, Sabina Dongol, Abhilasha Karkey, Marcel Wolbers, Stephen Baker, Guy Thwaites

Abstract

Undifferentiated febrile illness (UFI) includes typhoid and typhus fevers and generally designates fever without any localizing signs. UFI is a great therapeutic challenge in countries like Nepal because of the lack of available point-of-care, rapid diagnostic tests. Often patients are empirically treated as presumed enteric fever. Due to the development of high-level resistance to traditionally used fluoroquinolones against enteric fever, azithromycin is now commonly used to treat enteric fever/UFI. The re-emergence of susceptibility of Salmonella typhi to co-trimoxazole makes it a promising oral treatment for UFIs in general. We present a protocol of a randomized controlled trial of azithromycin versus co-trimoxazole for the treatment of UFI. This is a parallel-group, double-blind, 1:1, randomized controlled trial of co-trimoxazole versus azithromycin for the treatment of UFI in Nepal. Participants will be patients aged 2 to 65 years, presenting with fever without clear focus for at least 4 days, complying with other study criteria and willing to provide written informed consent. Patients will be randomized either to azithromycin 20 mg/kg/day (maximum 1000 mg/day) in a single daily dose and an identical placebo or co-trimoxazole 60 mg/kg/day (maximum 3000 mg/day) in two divided doses for 7 days. Patients will be followed up with twice-daily telephone calls for 7 days or for at least 48 h after they become afebrile, whichever is later; by home visits on days 2 and 4 of treatment; and by hospital visits on days 7, 14, 28 and 63. The endpoints will be fever clearance time, treatment failure, time to treatment failure, and adverse events. The estimated sample size is 330. The primary analysis population will be all the randomized population and subanalysis will be repeated on patients with blood culture-confirmed enteric fever and culture-negative patients. Both azithromycin and co-trimoxazole are available in Nepal and are extensively used in the treatment of UFI. Therefore, it is important to know the better orally administered antimicrobial to treat enteric fever and other UFIs especially against the background of fluoroquinolone-resistant enteric fever. ClinicalTrials.gov, ID: NCT02773407 . Registered on 5 May 2016.

Twitter Demographics

The data shown below were collected from the profiles of 7 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 107 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 107 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 15 14%
Student > Master 14 13%
Student > Bachelor 14 13%
Researcher 13 12%
Other 7 7%
Other 13 12%
Unknown 31 29%
Readers by discipline Count As %
Medicine and Dentistry 23 21%
Nursing and Health Professions 17 16%
Biochemistry, Genetics and Molecular Biology 13 12%
Agricultural and Biological Sciences 4 4%
Veterinary Science and Veterinary Medicine 3 3%
Other 14 13%
Unknown 33 31%

Attention Score in Context

This research output has an Altmetric Attention Score of 5. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 October 2017.
All research outputs
#6,136,398
of 23,005,189 outputs
Outputs from Trials
#2,227
of 5,932 outputs
Outputs of similar age
#98,923
of 322,939 outputs
Outputs of similar age from Trials
#51
of 127 outputs
Altmetric has tracked 23,005,189 research outputs across all sources so far. This one has received more attention than most of these and is in the 73rd percentile.
So far Altmetric has tracked 5,932 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 8.2. This one has gotten more attention than average, scoring higher than 62% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 322,939 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 69% of its contemporaries.
We're also able to compare this research output to 127 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 59% of its contemporaries.