Multidrug-resistant typhoid fever.
OBJECTIVE
To study the epidemiological pattern, clinical picture, the recent trends of multidrug-resistant typhoid fever (MDRTF), and therapeutic response of ofloxacin and ceftriaxone in MDRTF.


METHODS
The present prospective randomized controlled parallel study was conducted on 93 blood culture-proven Salmonella typhi children. All MDRTF cases were randomized to treatment with ofloxacin or ceftriaxone.


RESULTS
Of 93 children, 62 (66.6%) were MDRTF. 24 cases were below 5 years, 26 between 5-10 years and 12 were above 10 years. Male to female ratio was 1.85: 1. Majority of cases came from lower middle socio-economic classes with poor personal hygiene. Fever was the main presenting symptom. Hepatomegaly and splenomegaly was present in 88% and 46% cases respectively. 19 (30.6%) cases developed complications. Mean defervescence time with ceftriaxone and ofloxacin was 4.258 and 4.968 days respectively.


CONCLUSIONS
MDRTF is still emerging as serious public and therapeutic challenge. Ceftriaxone is well-tolerated and effective drug but expensive whereas ofloxacin is safe, cost-effective and therapeutic alternative in treatment of MDRTF in children with comparable efficacy to ceftriaxone.
Kumar
Rajiv
R
Department of Pediatrics, Batra Hospital & Medical Research Centre, New Delhi, India. drrajivkumar@hotmail.com
Gupta
Nomeeta
N
D000284:Administration, Oral; D001769:Blood / Q000382:microbiology; D002443:Ceftriaxone / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D008826:Microbial Sensitivity Tests; D015242:Ofloxacin / Q000008:administration & dosage*; D011336:Probability; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012485:Salmonella typhi / Q000187:drug effects* / Q000302:isolation & purification; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality
D002443:Ceftriaxone; D015242:Ofloxacin