title: Treatment of typhoid fever in children with a flexible-duration of ceftriaxone, compared with 14-day treatment with chloramphenicol.
abstract: Although the efficacy of ceftriaxone in typhoid fever is well documented, the precise duration of ceftriaxone therapy in children with typhoid fever is not established and varies from 3 to 14 days in the literature. In a prospective, randomized study ceftriaxone was compared with chloramphenicol for treatment of 72 children who had bacteriologically confirmed typhoid fever. Ceftriaxone was given at a dose of 75 mg/kg per day (maximally 2 g/day) intravenously, in two doses until defervescence and continued 5 days after that time. Chloramphenicol was given at a dose of 75 mg/kg per day (maximally 2 g/day) in four doses for 14 days. Mean defervescence time was in 5.4 days in the ceftriaxone group and 4.2 days in the chloramphenicol group (P=0.04). Clinical cure without complications was achieved in all patients in both groups. No patient relapsed in the ceftriaxone group, and four patients relapsed in the chloramphenicol group (P=0.048). The overall results of this study suggest that a flexible-duration of ceftriaxone therapy given until defervescence time, followed by an additional 5 days of therapy is a reasonable alternative to conventional 14-day chloramphenicol treatment in children with typhoid fever.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Harran University, Sanliurfa, Turkey. mansurtatli@hotmail.com
authors.forename: Mustafa Mansur
authors.initials: MM
authors.lastname: Tatli
authors.forename: Guler
authors.initials: G
authors.lastname: Aktas
authors.forename: Mustafa
authors.initials: M
authors.lastname: Kosecik
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Yilmaz
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002701:Chloramphenicol / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D014435:Typhoid Fever / Q000097:blood / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D002701:Chloramphenicol; D002443:Ceftriaxone