Randomized Treatment of Patients with Typhoid Fever by Using Ceftriaxone or Chloramphenicol

Sixty-three patients with Salmonella typhi infections were randomly assigned to receive either ceftriaxone iv in single daily doses of 75 mg/kg for children and 3–4 g for adults for seven days or to receive 60 mg of chloramphenicol/kg a day orally or iv in four divided doses until defervescence and...

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Bibliographic Details
Published in:The Journal of infectious diseases 1988-10, Vol.158 (4), p.742-747
Main Authors: Islam, Asma, Butler, Thomas, Nath, Samir K., Alam, Nurul H., Stoeckel, Klaus, Houser, Harold B., Smith, Arnold L.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Adults
Antibiotics
Blood
Bone marrow
Ceftriaxone - blood
Ceftriaxone - therapeutic use
Cephalosporins
Child
Child, Preschool
Chloramphenicol - blood
Chloramphenicol - therapeutic use
Cultural groups
Diarrhea
Dosage
Feces - microbiology
Female
Fever
Hematocrit
Humans
Infant
Leukocyte Count
Major Articles
Male
Middle Aged
Platelet Count
Random Allocation
Salmonella typhi
Salmonella typhi - drug effects
Typhoid fever
Typhoid Fever - drug therapy
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Summary:Sixty-three patients with Salmonella typhi infections were randomly assigned to receive either ceftriaxone iv in single daily doses of 75 mg/kg for children and 3–4 g for adults for seven days or to receive 60 mg of chloramphenicol/kg a day orally or iv in four divided doses until defervescence and then 40 mg/kg a day to complete 14 d. In the ceftriaxone group, one death occurred, and two of seven patients still febrile 11 d after starting treatment were given chloramphenicol. In the chloramphenicol group, one death and one gastrointestinal perforation occurred. The probability of remaining febrile was similar for both groups during the first seven days but was significantly greater for patients receiving ceftriaxone during the 14-dperiod. Patients in the chloramphenicol group weremore likely to be bacteremic on day 3. These results suggest that a seven-day course of once-daily ceftriaxone shows promise as an alternative to 14 d of chloramphenicol for treating typhoid fever.
ISSN:0022-1899
1537-6613
DOI:10.1093/infdis/158.4.742