title: Treatment of Japanese patients with enteric fever using azithromycin and MIC levels for causative organisms.
abstract: In Japan azithromycin (AZM) has been used to treat enteric fever caused by bacteria with resistance to fluoroquinolones; however, the dose, length of treatment and effectiveness of AZM among Japanese patients with enteric fever is unclear. We studied 5 Japanese adults and 1 Japanese child with enteric fever (4 had typhoid fever and 2 had paratyphoid fever) who were treated with oral AZM. The treatment regimens were: 1,000 mg as a single or in 2 divided doses on the 1st day, followed by 500 mg as a single dose daily for 5-6 additional days, or 500 mg as a single dose daily for 10 days. The minimum inhibitory concentrations (MICs) for AZM against 5 causative organisms were investigated with an E-test. Good clinical results were observed in the 5 adult patients but treatment failure was seen in the 1 child patient with typhoid fever; no adverse reactions were found. MICs of AZM were 4 microg/ml against S. Typhi in 2 patients, 8 microg/ml against S. Typhi in 2 patients, and 32 microg/ml against S. Paratyphi A in 1 patient. Our findings indicate AZM may be a reasonable choice for treatment of Japanese adult patients with enteric fever.
authors.affiliation: Department of Infectious Diseases, Tokyo Metropolitan Bokutoh General Hospital, Tokyo, Japan. infection@bokutoh-hp.metro.tokyo.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Ohnishi
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Sentaro
authors.initials: S
authors.lastname: Iwabuchi
authors.forename: Fukumi
authors.initials: F
authors.lastname: Nakamura-Uchiyama
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D017963:Azithromycin / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008826:Microbial Sensitivity Tests; D010284:Paratyphoid Fever / Q000188:drug therapy*; D014435:Typhoid Fever / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin