Failure of short-course ceftriaxone chemotherapy for multidrug-resistant typhoid fever in children: a randomized controlled trial in Pakistan.
The precise duration of therapy of multidrug-resistant (MDR) typhoid with broad-spectrum cephalosporins is uncertain. We prospectively randomized 57 children with culture-proven MDR typhoid to receive treatment with intravenous ceftriaxone (CRO) (65 mg/kg of body weight/day) for 7 days (short course; n = 29) or 14 days (conventional; n = 28). The response to therapy, as evaluated by the serial monitoring of the typhoid morbidity score and bacteriological clearance, was comparable between groups. In contrast to the conventional therapy, 14% of the children receiving CRO for 7 days had a confirmed bacteriological relapse within 4 weeks of stopping therapy.
Bhutta
Z A
ZA
Department of Paediatrics, The Aga Khan University, Karachi, Pakistan. zulfiqar.bhutta@aku.edu
Khan
I A
IA
Shadmani
M
M
D002443:Ceftriaxone / Q000008:administration & dosage / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D018432:Drug Resistance, Multiple / Q000235:genetics; D006801:Humans; D010154:Pakistan; D012008:Recurrence; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control
D002511:Cephalosporins; D002443:Ceftriaxone