title: Management of typhoid.
abstract: Typhoid fever is still a major problem in developing Third World countries where socioeconomic conditions and standards of hygiene are still well below standard. Prophylaxis is far from satisfactory. However, recent developments using live oral vaccines are encouraging. Specific treatment for the disease consists of chloramphenicol or co-trimoxazole; amoxycillin and ampicillin are inferior agents but are of value in several situations because their potential toxic effects are less marked. Most other agents also have drawbacks or are relatively ineffective. In the severely toxic patient, corticosteroids seem to affect prognosis favourably. Of the many other acute complications of typhoid fever, ileal perforation is the most serious; there is still controversy concerning the respective roles of conservative and surgical management, but it is clear that individual cases must be assessed on their merit. Amoxycillin, because it is very rapidly absorbed and produces very high blood concentrations, is probably the best antibiotic for the carrier state.
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000560:Amdinocillin / Q000627:therapeutic use; D000561:Amdinocillin Pivoxil / Q000627:therapeutic use; D000658:Amoxicillin / Q000627:therapeutic use; D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000892:Anti-Infective Agents, Urinary / Q000627:therapeutic use; D002353:Carrier State / Q000628:therapy; D002701:Chloramphenicol / Q000627:therapeutic use; D004338:Drug Combinations / Q000627:therapeutic use; D005664:Furazolidone / Q000627:therapeutic use; D006801:Humans; D013420:Sulfamethoxazole / Q000627:therapeutic use; D014295:Trimethoprim / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014435:Typhoid Fever / Q000188:drug therapy* / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy; D014436:Typhoid-Paratyphoid Vaccines / Q000627:therapeutic use; D014882:Water-Electrolyte Balance
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D000892:Anti-Infective Agents, Urinary; D004338:Drug Combinations; D014436:Typhoid-Paratyphoid Vaccines; D000561:Amdinocillin Pivoxil; D005664:Furazolidone; D002701:Chloramphenicol; D000667:Ampicillin; D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D014295:Trimethoprim; D013420:Sulfamethoxazole; D000560:Amdinocillin