Comparative Analysis of combination antibiotic therapy versus Standard Care in dengue fever
DOI:
https://doi.org/10.5281/zenodo.22812032Keywords:
dengue fever, combination antibiotic therapy, secondary bacterial infection, bacterial coinfection, standard supportive careAbstract
Background: Dengue has no antiviral or antibacterial cure, yet a minority of hospitalized patients carry a secondary bacterial infection, co-infection, or a bacterial mimic such as leptospirosis or scrub typhus [7,8,9].
Objective: This comparative analysis synthesizes evidence on bacterial infection in dengue and on outcomes when combination antibiotic therapy is added to standard supportive care in that subgroup.
Methods: We synthesized cohort studies, case series, and trial evidence identified through PubMed and citation tracking, prioritizing studies reporting confirmed bacterial infection or outcomes stratified by antibiotic exposure or sepsis status.
Findings: Secondary bacterial infection is reported in roughly 8-15% of hospitalized dengue cohorts, rising with prolonged fever or sepsis [12,14], and community-acquired sepsis carries a substantially higher case-fatality proportion than dengue alone, favouring prompt combination antibiotic therapy once sepsis is identified [15,16]. Indiscriminate antibiotic use without identified bacterial infection shows no demonstrated benefit [20].
Conclusions: Combination antibiotic therapy has no role in dengue as such, but an evidence-supported role in the identifiable minority with bacterial infection or a mimic; how quickly that minority can be identified at the bedside remains the central open question, absent a randomized trial against standard care alone.
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