Short-course azithromycin for the treatment of uncomplicated typhoid fever in children and adolescents.
We studied 149 children and adolescents 3-17 years of age with clinical typhoid fever who were treated with either oral azithromycin (20 mg/kg per day; maximum dose, 1000 mg/day) or intravenous ceftriaxone (75 mg/day; maximum dose, 2.5 g/day) daily for 5 days. Blood and stool specimens were obtained for culture before the initiation of therapy and were repeated on days 4 and 8 of treatment. Isolation of Salmonella enterica serovar Typhi or S. enterica serovar Paratyphi from the initial culture was required for inclusion in the final analysis. S. Typhi was isolated from 68 patients, 32 of whom were receiving azithromycin. Cure was achieved in 30 (94%) of 32 patients in the azithromycin group and in 35 (97%) of 36 patients in the ceftriaxone group (P=NS). Mean time to clearance of bacteremia was longer in the azithromycin group than in the ceftriaxone group. No patient who received azithromycin had a relapse, compared with 6 patients who received ceftriaxone. A 5-day course of azithromycin was found to be an effective treatment for uncomplicated typhoid fever in children and adolescents.
Frenck
Robert W
RW
US Naval Medical Research Unit #3, Cairo, Egypt. FrenckR@namru3.org
Mansour
Adel
A
Nakhla
Isabelle
I
Sultan
Yehia
Y
Putnam
Shannon
S
Wierzba
Thomas
T
Morsy
Mosaad
M
Knirsch
Charles
C
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D012480:Salmonella Infections / Q000188:drug therapy*; D012482:Salmonella paratyphi A / Q000187:drug effects; D012485:Salmonella typhi / Q000187:drug effects; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D017963:Azithromycin