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Ciprofloxacin versus ceftriaxone in the treatment of multiresistant typhoid fever

  • M. R. Wallace
  • A. A. Yousif
  • G. A. Mahroos
  • T. Mapes
  • E. J. Threlfall
  • B. Rowe
  • K. C. Hyams
Article

Abstract

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.

Keywords

Internal Medicine Treatment Option Blood Culture Ceftriaxone Resistant Strain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Friedr. Vieweg & Sohn Verlagsgesellschaft mbH 1993

Authors and Affiliations

  • M. R. Wallace
    • 1
    • 2
  • A. A. Yousif
    • 2
  • G. A. Mahroos
    • 2
  • T. Mapes
    • 3
  • E. J. Threlfall
    • 4
  • B. Rowe
    • 4
  • K. C. Hyams
    • 5
  1. 1.Department of Internal Medicine, Infectious Disease Division, and Department of Clinical InvestigationNaval HospitalSan DiegoUSA
  2. 2.Salmaniya Medical CentreManamaBahrain
  3. 3.United States Naval Medical Research Unit No. 3CairoEgypt
  4. 4.Public Health Laboratory ServiceWHO Collaborating Centre for Phage Typing and Resistance in Enterobacteria, Division of Enteric PathogensLondonUK
  5. 5.Naval Medical Research InstituteEpidemiology DivisionBethesdaUSA

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