A Prospective Study of Efficacy and Safety of Azithromycin and Ofloxacin in the treatment of Typhoid Fever in Children at a Tertiary Care Hospital

  • C M Kamaal Department, of Pharmacology, SMMH Government Medical College, Saharanpur, India
  • Vishal P Giri Department of Pharmacology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad
  • Imtiyaz Ahmad Shah Department of Pharmacology, Teerthanker Mahaveer Medical College and Research Centre, Moradabad
Keywords: Typhoid fever, Ofloxacin, Azithromycin.

Abstract

Introduction: Antimicrobial therapy is the mainstay for the treatment of Typhoid fever that shortens the clinical course of typhoid fever and reduces the risk of death. For decades, chloramphenicol has been highly effective against S. typhi, but multi-drug resistant (MDR) strains of S. typhi (resistant to chloramphenicol, trimethoprim sulfamethoxazole, and ampicillin) has restricted its use in typhoid fever.

Objective: To compare the efficacy and safety of Azithromycin and Ofloxacin in children suffering from uncomplicated typhoid fever.

Methods: Blood culture proven, uncomplicated typhoid fever patients admitted in the pediatric ward of J. N. Medical college, Aligarh were treated with ofloxacin orally (15mg/kg/24 hrs BD for 5 days) and azithromycin orally (10mg/kg/24 hrs OD on Day 1, then 5mg/kg OD for next 4 days). Patients were clinically and bacteriologically evaluated during the study period and follow-up.

Results: 96.7 % cure rate was observed in azithromycin group. No relapse was recorded.

Conclusion: Both Ofloxacin as well as azithromycin may be considered as an empirical therapy for  the  treatment of uncomplicated  typhoid in  children .

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References

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9. Brooks WA, Hossain A, Goswami D, Nahar K,Alam K, Ahmed N. Bacteremic typhoid feverin children in an urban slum, Bangladesh.Emerg Infect Dis 2005; 11:326-9.
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11. Geetha VK, Yugendran T, Srinivasan R, Harish BN. Plasmidmediatedquinolone resistance in typhoidal Salmonellae: apreliminary report from South India. Indian J Med Microbiol.2014;32(1):31-4.
12. Frenck RW Jr, Mansour A, Nakhla I, Sultan Y. Short-course azithromycin for the treatment of uncomplicated typhoid fever in children and adolescents. Clin Infect Dis. 2004;1;38(7):951-57.
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14. Giri OP. Therapy of typhoid fever. Patna journal of medicine. 1992: 66(6); 124-25.
15. Gosai MM, Hareshwaree HB, PurohitPH, Abeda MG. A study of clinical profileof multidrug resistant typhoid fever inchildren. NJIRM 2011; 2:87-90.
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1. Lesser CF, Miller SI. Salmonellosis. In: Braunwald E, FauciAS,Kasper DL, Hauser SL, Longo DL, Jameson JL editor(s). Harrison’sPrinciples of Internal Medicine. 15th Edition. Vol. 1, New York:McGraw-Hill, 2001:971-73.
2. Buckle GC, Walker CL, Black RE. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010. J Glob Health. 2012;2(1):10401-05.
3. Background document: The diagnosis, treatment and prevention of typhoid fever. Communicable Disease Surveillance and Response Vaccines and Biologicals. World Health Organization [Internet] [cited 2015 April 6]. Available from: http://www.who. int/rpc/TFGuideWHO.pdf.
4. Giri OP. Study of cerebrospinal fluid in Salmonella typhi meningitis. The Journal of the Association of Physicians of India. 1993 Mar;41(3):154.
5. Typhoid infection diagnosis – step-by-step.BMJ Best Practice [Internet] [cited 2015April 7]. Available from: http://bestpractice.bmj.com/best-practice/monograph/221/diagnosis/step-by-step.html.
6. Butler T. Treatment of enteric fever in the21st century: promises and shortcomings.ClinMicrobiol Infect 2011; 17:959-63.
7. Manzoor A, Mahmood T, Zulfiqar R. Azithromycin Versus Ofloxacin in Treatment of Enteric Fever in Children. Journal of Rawalpindi Medical College. 2014;18(2):209-12.
8. Rupali P, Abraham OC, Jesudason MV, John TJ, Zachariah A, Sivaram S et al. Treatment failure in typhoid fever with ciprofloxacin susceptible Salmonella typhoida serotype Typhi. Diagn Microbiol Infect Dis. 2004 ;49(1):1-3.
9. Brooks WA, Hossain A, Goswami D, Nahar K,Alam K, Ahmed N. Bacteremic typhoid feverin children in an urban slum, Bangladesh.Emerg Infect Dis 2005; 11:326-9.
10. Singhal L, Gupta PK, Kale P, Gautam V, Ray P. Trendsin antimicrobial susceptibility of Salmonella typhifrom North India (2001-2012). Indian J Med Microbiol2014;32(2):149-52.
11. Geetha VK, Yugendran T, Srinivasan R, Harish BN. Plasmidmediatedquinolone resistance in typhoidal Salmonellae: apreliminary report from South India. Indian J Med Microbiol.2014;32(1):31-4.
12. Frenck RW Jr, Mansour A, Nakhla I, Sultan Y. Short-course azithromycin for the treatment of uncomplicated typhoid fever in children and adolescents. Clin Infect Dis. 2004;1;38(7):951-57.
13. Giri VP, Giri OP, Srivastava A, Mishra C, Kumar A, Kanodia S. A clinical trial of treatment of uncomplicated typhoid fever: efficacy of ceftriaxone-azithromycin combination. Int J Basic ClinPharmacol. 2015; 4(4): 673-677. doi:10.18203/2319-2003.ijbcp20150370.
14. Giri OP. Therapy of typhoid fever. Patna journal of medicine. 1992: 66(6); 124-25.
15. Gosai MM, Hareshwaree HB, PurohitPH, Abeda MG. A study of clinical profileof multidrug resistant typhoid fever inchildren. NJIRM 2011; 2:87-90.
16. Giri OP. Current chemotherapeutic profile of typhoid fever. Patna journal of medicine. 1992: 66(7); 155-56.
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Published
2016-03-20
How to Cite
1.
Kamaal C, Giri V, Shah I. A Prospective Study of Efficacy and Safety of Azithromycin and Ofloxacin in the treatment of Typhoid Fever in Children at a Tertiary Care Hospital. IABCR [Internet]. 20Mar.2016 [cited 21Jul.2019];2(1):23-8. Available from: https://iabcr.org/index.php/iabcr/article/view/226