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Multidrug-resistant typhoid fever.

Rajiv Kumar1, Nomeeta Gupta,

  • 1Department of Pediatrics, Batra Hospital & Medical Research Centre, New Delhi, India. drrajivkumar@hotmail.com

Indian Journal of Pediatrics
|February 1, 2007
PubMed
Summary
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Multidrug-resistant typhoid fever (MDRTF) is a growing concern in children. Ofloxacin offers a safe, cost-effective, and effective treatment alternative comparable to ceftriaxone.

Area of Science:

  • Pediatric Infectious Diseases
  • Microbiology
  • Clinical Pharmacology

Background:

  • Multidrug-resistant typhoid fever (MDRTF) presents a significant public health challenge.
  • Understanding the epidemiological patterns and clinical features of MDRTF in children is crucial for effective management.

Purpose of the Study:

  • To investigate the epidemiology and clinical presentation of MDRTF in children.
  • To evaluate the therapeutic efficacy and response of ofloxacin and ceftriaxone in treating MDRTF in pediatric patients.

Main Methods:

  • A prospective randomized controlled parallel study involving 93 children with blood culture-proven Salmonella typhi.
  • Children diagnosed with MDRTF were randomized to receive either ofloxacin or ceftriaxone treatment.

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Main Results:

  • Multidrug-resistant typhoid fever (MDRTF) was identified in 66.6% of the pediatric cases.
  • Fever was the predominant symptom, with hepatomegaly (88%) and splenomegaly (46%) also common. Complications occurred in 30.6% of cases.
  • Mean defervescence times were 4.26 days for ceftriaxone and 4.97 days for ofloxacin.

Conclusions:

  • MDRTF poses a serious and emerging public health and therapeutic challenge in pediatric populations.
  • Ceftriaxone is effective but costly, while ofloxacin presents a safe, cost-effective, and therapeutically comparable alternative for MDRTF treatment in children.