Comparative trial of short-course ofloxacin for uncomplicated typhoid fever in Vietnamese children

• Published in: Annals of tropical paediatrics 2005-03, Vol.25 (1), p.17-22
• Main Authors: Vinh, Ha, Duong, Nguyen Minh, Phuong, Le Thi, Truong, Nguyen Thanh, Bay, Phan Van Be, Wain, John, Diep, To Song, Ho, Vo Anh, White, Nicholas J., Day, Nicholas P.J., Parry, Christopher M.
• Format: Article
• Language: English
• Subjects: Administration, Oral; Adolescent; Anti-Bacterial Agents - administration & dosage; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Child; Child, Preschool; Drug Administration Schedule; Drug Resistance, Multiple, Bacterial; Female; Human bacterial diseases; Humans; Infectious diseases; Length of Stay; Male; Medical sciences; Ofloxacin - administration & dosage; Salmonella typhi - drug effects; Salmonella typhi - isolation & purification; Treatment Outcome; Typhoid Fever - drug therapy; Typhoid Fever - epidemiology; Typhoid Fever - microbiology; Vietnam - epidemiology
• ISSN: 0272-4936; 2046-9047; 1465-3281; 2046-9055
• DOI: 10.1179/146532805X23308

An open, randomised comparison of 2 or 3 days of oral ofloxacin (10 mg/kg/day) for uncomplicated typhoid fever was conducted in 235 Vietnamese children. Multi-drug-resistant Salmonella typhi was isolated from 182/202 (90%) children and 5/166 (3%) tested isolates were nalidixic acid-resistant (Na R ). Eighty-nine of 116 children randomised to 2 days and 107/119 randomised to 3 days were blood culture-positive and eligible for analysis. There were 12 (13.5%) failures in the 2-day group (six clinical failures, four blood culture-positive post treatment, two relapses) compared with eight (7.5%) failures in the 3-day group (four clinical failures, one blood culture-positive post treatment, three relapses) (OR 1.9, 95% CI 0.7-5.5,p = 0.17). There were no significant differences in the mean (95% confidence interval) fever clearance times (h) [92 (82−102) vs 101 (93−110), p = 0.18] or duration of hospitalisation (d) [7.6 (7.2−8.1) vs 8.0 (7.6−8.4), p = 0.19] between the two groups. There was one failure in the four eligible children infected with an Na R isolate of S. typhi. No adverse events were attributable to the ofloxacin. These results extend previous observations on the efficacy of short courses of ofloxacin for children with uncomplicated multi-drug-resistant typhoid fever.