A randomized comparison of oral chloramphenicol versus ofloxacin in the treatment of uncomplicated typhoid fever in Laos.
We conducted a randomized open trial of oral chloramphenicol (50mg/kg/day in four divided doses for 14 days) versus ofloxacin (15 mg/kg/day in two divided doses for 3 days) in 50 adults with culture-confirmed uncomplicated typhoid fever in Vientiane, Laos. Patients had been ill for a median (range) of 8 (2-30) days. All Salmonella enterica serotype typhi isolates were nalidixic acid-sensitive, four (8%) were chloramphenicol-resistant and three (6%) were multidrug-resistant. Median (range) fever clearance times were 90 (24-224) hours in the chloramphenicol group and 54 (6-93) hours in the ofloxacin group (P<0.001). One patient in the chloramphenicol group developed an ileal perforation. Three days ofloxacin was more effective than 14 days chloramphenicol for the in-patient treatment of typhoid fever, irrespective of antibiotic susceptibility, and was of similar cost.
Phongmany
Simmaly
S
Mahosot Hospital, Vientiane, Laos.
Phetsouvanh
Rattanaphone
R
Sisouphone
Siho
S
Darasavath
Chirapha
C
Vongphachane
Pankham
P
Rattanavong
Oudayvone
O
Mayxay
Mayfong
M
Ramsay
Andrew C
AC
Blacksell
Stuart D
SD
Thammavong
Chanpheng
C
Syhavong
Bounkong
B
White
Nicholas J
NJ
Newton
Paul N
PN
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use*; D002701:Chloramphenicol / Q000008:administration & dosage* / Q000191:economics; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007812:Laos / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015242:Ofloxacin / Q000191:economics / Q000627:therapeutic use*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000188:drug therapy* / Q000453:epidemiology
D000900:Anti-Bacterial Agents; D002701:Chloramphenicol; D015242:Ofloxacin