Therapy of multidrug resistant typhoid in 58 children.
Treatment of children with infections caused by Salmonella typhi strains resistant to the commonly used oral antimicrobials is a special problem. As children cannot be treated with quinolones, there is no form of oral therapy. Third generation cephalosporins, which have been shown to be effective against typhoid caused by ampicillin sensitive strains of S. typhi were effective against typhoid caused by ampicillin, chloramphenicol and sulfamethoxazole/trimethoprim-resistant strains. We treated 28 children with ceftriaxone and 8 with cefotaxime. We found ceftriaxone to be more effective than cefotaxime with significantly lower relapse rate. Antibiotic therapy of 19 other children, initially treated in a similar manner, was altered for ease of therapy or due to poor response to therapy. The high cost of this parenteral therapy and the problems in its delivery point to the need for safe, effective oral therapy.
Naqvi
S H
SH
Department of Pediatrics, Faculty of Health Sciences, Aga Khan University and Hospital, Karachi, Pakistan.
Bhutta
Z A
ZA
Farooqui
B J
BJ
D000293:Adolescent; D000668:Ampicillin Resistance; D001398:Aztreonam / Q000494:pharmacology / Q000627:therapeutic use; D002439:Cefotaxime / Q000494:pharmacology / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002702:Chloramphenicol Resistance; D004352:Drug Resistance, Microbial; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015242:Ofloxacin / Q000494:pharmacology; D012485:Salmonella typhi / Q000187:drug effects*; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology; D014435:Typhoid Fever / Q000188:drug therapy* / Q000382:microbiology
D002443:Ceftriaxone; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D015242:Ofloxacin; D001398:Aztreonam; D002439:Cefotaxime