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Cefpodoxime proxetil compared with cefixime for treatment of typhoid fever in children

Md Salim Shakur1, Selina Akhter Laila Arzuman, Jesmin Hossain

  • 1Dhaka Shishu (Children) Hospital, ShereBangla Nagar, Dhaka 1207, Bangladesh. njshantu@yahoo.com

Indian Pediatrics
|December 7, 2007
PubMed

Insights

Cefpodoxime Proxetil (CP) is an effective and safe oral treatment for pediatric typhoid fever, offering similar clinical outcomes to cefixime (CF) but at a lower cost. This study highlights CP as a cost-effective alternative for managing this common childhood infection.

Area of Science:

  • Pediatric Infectious Diseases
  • Clinical Pharmacology
  • Antimicrobial Therapy

Background:

  • Typhoid fever remains a significant public health concern, particularly in children.
  • Effective oral antibiotic options are crucial for managing typhoid fever, impacting treatment accessibility and cost.
  • Cefpodoxime Proxetil (CP) and cefixime (CF) are third-generation cephalosporins used for bacterial infections.

Purpose of the Study:

  • To compare the clinical and bacteriological efficacy of oral Cefpodoxime Proxetil (CP) versus oral cefixime (CF) in children with culture-confirmed typhoid fever.
  • To evaluate safety, relapse rates, and cost-effectiveness of CP compared to CF.
  • To provide evidence for CP as a potential alternative treatment for pediatric typhoid fever.

Main Methods:

  • A randomized, double-blind clinical trial involving 40 children with culture-confirmed typhoid fever.
  • Participants were assigned to receive either oral CP (16 mg/kg/day) or oral CF (20 mg/kg/day) for 10 days.
  • Clinical and bacteriological outcomes, including time to defervescence, clinical failures, eradication rates, and adverse effects, were assessed.

Main Results:

  • Both CP and CF demonstrated similar clinical efficacy, with low rates of clinical failure (1 in each group).
  • Bacteriological eradication was achieved in all participants following treatment with either antibiotic.
  • The time to defervescence was comparable between the CP and CF groups (4.87 +/- 2.33 vs 4.27 +/- 2.28 days, P = 0.308).
  • No significant adverse effects or relapses were observed during the 3-month follow-up period.
  • CP treatment resulted in a 33% reduction in treatment cost compared to CF.

Conclusions:

  • Cefpodoxime Proxetil (CP) is a clinically effective and safe oral option for treating typhoid fever in children.
  • CP offers comparable efficacy to cefixime (CF) with the added benefit of being more cost-effective.
  • CP represents a valuable and economical therapeutic choice for pediatric typhoid fever management.

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