Ciprofloxacin versus ceftriaxone in the treatment of multiresistant typhoid fever

  title={Ciprofloxacin versus ceftriaxone in the treatment of multiresistant typhoid fever},
  author={MarkR. Wallace and Aziz A. Yousif and Ghazi Al Mahroos and T Mapes and E. John Threlfall and Bernard Rowe and Kenneth Craig Hyams},
  journal={European Journal of Clinical Microbiology and Infectious Diseases},
  • M. Wallace, A. Yousif, K. Hyams
  • Published 1 December 1993
  • Medicine, Biology
  • European Journal of Clinical Microbiology and Infectious Diseases
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… 
To compare the effectiveness of oral azithromycin versus intravenous ceftriaxone for treating uncomplicated enteric fever
Oral azithromycin was more efficacious in the treatment of uncomplicated enteric fever in children as compared to IV ceftriaxone.
Persistence of Salmonellae in Blood and Bone Marrow: Randomized Controlled Trial Comparing Ciprofloxacin and Chloramphenicol Treatments against Enteric Fever
Although ciprofloxacin was more effective in the elimination of Salmonellaenterica serovars Typhi and Paratyphi A from bone marrow than chloramphenicol, there was still an impressive persistence of Salbornella in the bone marrow culture.
Treatment of typhoid fever in the 21st century: promises and shortcomings.
  • T. Butler
  • Medicine, Biology
    Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
  • 2011
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Response of extensively drug resistant Salmonella Typhi to treatment with meropenem and azithromycin, in Pakistan
The clinical manifestations and the response to treatment of patients with XDR Typhoid fever are reported and because of the lower cost of azithromycin, it is preferable in lower socio-economic areas.
Bactericidal activities and post-antibiotic effects of ofloxacin and ceftriaxone against drug-resistant Salmonella enterica serovar Typhi
The slow bactericidal activity of ceftriaxone and absent PAE may explain the slow clinical response in typhoid and Infections with S. Typhi with intermediate ofloxacin susceptibility may respond to doses that maintain oflOxacin concentrations at 4×MIC at the site of infection.
Randomized Controlled Comparison of Ofloxacin, Azithromycin, and an Ofloxacin-Azithromycin Combination for Treatment of Multidrug-Resistant and Nalidixic Acid-Resistant Typhoid Fever
Uncomplicated typhoid fever due to isolates of MDR S. enterica serovar Typhi with reduced susceptibility to fluoroquinolones (Nar) can be successfully treated with a 7-day course of azithromycin.
Antibiogram Profile of Salmonella enterica Serovar Typhi in India - A Two Year Study.
The low proportion of MDR strains increases the possibility of first-line drugs for the treatment of typhoid fever and calls into question the further use of ciprofloxacin for the Treatment of Typhoid fever because of potential treatment failures.
Azithromycin and ceftriaxone in uncomplicated typhoid fever in paediatric patients: a prospective, comparative and randomized open labelled trail
XDR strain of Salmonella typhi has been reported which is resistant to most antibiotics (ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, ciprofloxacin, and ABSTRACT).


Randomized treatment of patients with typhoid fever by using ceftriaxone or chloramphenicol.
It is suggested that a seven-day course of once-daily ceftriaxone shows promise as an alternative to 14 d of chloramphenicol for treating typhoid fever.
Failure of ciprofloxacin to eradicate convalescent fecal excretion after acute salmonellosis: experience during an outbreak in health care workers.
Despite its excellent antimicrobial activity against Salmonellae and its favorable pharmacokinetic profile, ciprofloxacin at a dosage of 750 mg orally twice daily had an unacceptably high failure rate in patients with acute salmonellosis and may have prolonged fecal excretion of salmoneLLae.
Multidrug-resistant typhoid in children: presentation and clinical features.
Compared with children infected by drug-susceptible strains of Salmonella, children with multiresistant infection were generally sicker at presentation and were more likely to be assessed as appearing "toxic" (P less than .001), as having disseminated intravascular coagulation, and as exhibiting hepatomegaly (P more than .01).
Treatment of typhoid fever and infectious diarrhoea with ciprofloxacin.
  • A. Pithie, M. Wood
  • Medicine, Biology
    The Journal of antimicrobial chemotherapy
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Ciprofloxacin has excellent in-vitro activity against all the bacterial pathogens that commonly cause infective diarrhoea and appears to eliminate chronic carriage of Salm.
Once daily ceftriaxone vs. chloramphenicol for treatment of typhoid fever in children
In a prospective, randomized, open study ceftriaxone was compared with chloramphenicol for treatment of 59 children who had bacteriologically confirmed acute typhoid fever. Ceftriaxone was
Problems in salmonellosis: rationale for clinical trials with newer beta-lactam agents and quinolones.
Disease syndromes caused by Salmonella species continue to be important, as evidenced by a major outbreak of infection due to multiresistant Salmonella typhimurium in 1985; this outbreak involved
Multiresistant Salmonella organisms in India.
Resistance to chloramphenicol, ampicillin, co-trimoxazole, tetracycline, and streptomycin was found to be plasmid-mediated, and Salmonella typhi remains sensitive to nalidixic acid and the fluoroquino lones ciprofloxacin, oflaxacin; however, a decrease in resistance to these drugs is reported.
Multiple drug resistance in salmonellae in England and Wales: a comparison between 1981 and 1988.
The resistances to the common antimicrobial drugs in non-typhoidal salmonellas isolated in England and Wales in 1981 and 1988 were reported with particular reference to resistance to four or more antimicrobialdrugs (multiple resistance).
Spread of multiresistant strains of Salmonella typhimurium phage types 204 and 193 in Britain.
Characterisation of the resistance plasmids in the type 193 strains from both bovine and human sources showed that these strains had an identical plasmid content and represented a single clone.
The characterization of plasmids in the enterobacteria
The routine methods used in the Enteric Reference Laboratory for the study of enterobacterial plasmids are described and their value for the categorization of those Plasmids of diverse origin is discussed.