Ciprofloxacin versus ceftriaxone in the treatment of multiresistant typhoid fever
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
A randomized trial comparing ceftriaxone (3 g given parenterally per day for 7 days) to ciprofloxacin (500 mg given orally twice a day for 7 days) in the treatment of blood culture positive typhoid fever was conducted. Twenty patients were openly randomized to receive ciprofloxacin and 22 to receive ceftriaxone. The outcome was classified as clinical failure in 6 patients (27 %) in the ceftriaxone group, but in none in the ciprofloxacin group (p=0.01). The mean duration of fever was four days in the ciprofloxacin group and about five days in the ceftriaxone group (p=0.04). In the six patients in the ceftriaxone group who experienced failure, therapy was switched to ciprofloxacin and the patients became afebrile and asymptomatic within 48 hours. Patients with resistant strains ofSalmonella typhi and patients with sensitive strains responded equally well to ciprofloxacin therapy. Analysis of a subset of 12 of the multiresistant strains revealed that resistance was encoded for by a transferable 180 kilobase plasmid. Ciprofloxacin represents a useful treatment option in areas where multiresistant strains are likely to be encountered.
- Mandal BK Modern treatment of typhoid fever. Journal of Infection 1991, 22: 1–4. CrossRef
- Bryan JP, Rocha H, Scheld MW Problems in salmonellosis: rationale for clinical trials with newer beta-lactam agents and quinolones. Reviews of Infectious Diseases 1986, 8: 189–207.
- Rowe B, Ward LR, Threlfall EJ Spread of multiresistantSalmonella typhi. Lancet 1990, 336: 1065.
- Wallace MR, Yousif AA Spread of multiresistantSalmonella typhi. Lancet 1990, 336: 1065–1066.
- Bhutta ZA, Naqvi SH, Razzaq RA, Farooqui BJ Multidrug-resistant typhoid in children: presentation and clinical features. Reviews of Infectious Diseases 1991, 12: 832–836.
- Craigie J, Felix A Typing of typhoid bacilli with Vi bacteriophage. Lancet 1949, i: 823–827.
- Anderson ES, Threlfall EJ The characterization of plasmids in the enterobacteria. Journal of Hygiene 1974, 72: 481–487.
- Ward LR, Threlfall EJ, Rowe B Multiple drug resistance in salmonellae in England and Wales: a comparison between 1981 and 1988. Journal of Clinical Pathology 1990, 43: 563–566.
- Kado CI, Liu ST Rapid procedure for detection of large and small plasmids. Journal of Bacteriology 1981, 45: 1365–1373.
- Islam A, Butler T, Nath SK, Alam NH, Stoeckel K, Houser HB, Smith AL Randomized treatment of patients with typhoid fever by using ceftriaxone or chloramphenicol. Journal of Infectious Diseases 1988, 158: 742–747.
- Moosa A, Rubidge CJ Once daily ceftriaxone vs chloramphenicol for treatment of typhoid fever in children. Pediatric Infectious Disease Journal 1989, 8: 696–699.
- Pithie AD, Wood MJ Treatment of typhoid fever and infectious diarrhoea with ciprofloxacin. Journal of Antimicrobial Chemotherapy 1990, 26, Supplement F: 47–53.
- Anand AC, Kataria VK, Sing W, Chatterjee SK Epidemic multiresistant enteric fever in eastern India. Lancet 1990, 335: 352. CrossRef
- Rowe B, Ward LR, Threlfall EJ Treatment of multiresistant typhoid fever. Lancet 1991, 337: 1422. CrossRef
- Morris JG Efficacy of ciprofloxacin in the treatment of chronic typhoid carriers. Journal of Infectious Diseases 1988, 157: 1235–1238.
- Neill MA, Opal SM, Heelan J, Giusti R, Cassidy JE, White R, Mayer KH Failure of ciprofloxacin to eradicate convalescent fecal excretion after acute salmonellosis: experience during an outbreak in health care workers. Annals of Internal Medicine 1991, 114: 195–199.
- Mchta A, Rodriques C, Joshi VR MultiresistantSalmonella organisms in India. Journal of the American Medical Association 1991, 267: 1614.
- Ciprofloxacin versus ceftriaxone in the treatment of multiresistant typhoid fever
European Journal of Clinical Microbiology and Infectious Diseases
Volume 12, Issue 12 , pp 907-910
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Industry Sectors
- Author Affiliations
- 1. Department of Internal Medicine, Infectious Disease Division, and Department of Clinical Investigation, Naval Hospital, 92134-5000, San Diego, California, USA
- 2. Salmaniya Medical Centre, Manama, Bahrain
- 3. United States Naval Medical Research Unit No. 3, Cairo, Egypt
- 4. Public Health Laboratory Service, WHO Collaborating Centre for Phage Typing and Resistance in Enterobacteria, Division of Enteric Pathogens, London, UK
- 5. Naval Medical Research Institute, Epidemiology Division, Bethesda, Maryland, USA