Comparative efficacies of aztreonam and chloramphenicol in children with typhoid fever.
We compared aztreonam with chloramphenicol in a randomized trial involving the treatment of 36 children with typhoid fever. Eighteen children were randomized to receive aztreonam, 150 mg/kg/day intravenously, and 18 to receive chloramphenicol, 100 mg/kg/day orally. On entry in the study the clinical characteristics of the two treatment groups were comparable. The duration of therapy was 14.9 +/- 3.6 days for the aztreonam group and 12.8 +/- 2.6 days for the chloramphenicol group. The mean duration of fever was 5.9 +/- 3.1 days and 4.05 +/- 2.1 days for aztreonam and chloramphenicol groups respectively (P greater than 0.05). Clinical cure was observed in all patients treated with aztreonam and in 17 of 18 children given chloramphenicol; one patient died in the latter group. There were no relapses in either group. We observed clinical adverse reactions during the treatment with aztreonam in 2 patients. All strains of Salmonella typhi were susceptible to aztreonam, 1 strain was resistant to chloramphenicol and 3 strains were resistant to ampicillin. Aztreonam appears to be a satisfactory alternative to chloramphenicol in cases of typhoid fever caused by resistant strains or when chloramphenicol is contraindicated.
Departamento de Enfermedades Infecciosas y Parasitarias, Hospital Infantil de México, Federico Gómez, Mexico City.
J
J
Tanaka-Kido
L
L
Ortega
J I
JI
Santos
D000293:Adolescent; D000469:Alkaline Phosphatase / Q000097:blood; D001398:Aztreonam / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002701:Chloramphenicol / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D011897:Random Allocation; D014435:Typhoid Fever / Q000188:drug therapy*
D002701:Chloramphenicol; D000469:Alkaline Phosphatase; D001398:Aztreonam