An analysis of children with typhoid fever admitted in 1991.
In 28 children, with bacteriologically and/or serologically diagnosed typhoid fever treated at KEM Hospital, Bombay in 1991, initially one of the three recommended drugs (viz. chloramphenicol, amoxycillin or co-trimoxazole) was given for 7 days for defervescence to occur. In those who failed to respond, a second trial of therapy with one of the other two drugs was initiated, after omitting the first drug. A second failure of therapy was taken as an indication to use ciprofloxacin singly. Eventually, 18 (64.3%) cases responded to chloramphenicol or amoxycillin or co-trimoxazole. Ciprofloxacin was used in 19(35.7%) cases. the failure rate of treatment with chloramphenicol was 50%, with amoxycillin 71.4%, with co-trimoxazole 75% and 0% with ciprofloxacin. An analysis of the 28 cases revealed that apart from fever (in 100%), splenomegaly (in 82.1%) was the most important clinical pointer to diagnosis, along with absolute eosinopenia (in 71.4%). There were no major complications, except 2 cases with typhoid hepatitis who responded to choramphenicol and co-trimoxazole, respectively. Blood culture grew Salmonella typhi in 7 cases, of which 5 (72%) were multidrug resistant S. typhi. There were no characteristic clinical features to identify multi-drug resistant typhoid fever.
Deshmukh
C T
CT
Dept. of Pediatrics, KEM Hospital, Parel, Bombay, Maharashtra.
Nadkarni
U B
UB
Karande
S C
SC
D000658:Amoxicillin / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002648:Child; D002939:Ciprofloxacin / Q000627:therapeutic use; D006801:Humans; D010406:Penicillins / Q000627:therapeutic use; D013163:Splenomegaly; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014435:Typhoid Fever / Q000175:diagnosis / Q000188:drug therapy*
D000890:Anti-Infective Agents; D010406:Penicillins; D002939:Ciprofloxacin; D000658:Amoxicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination