Hydrocortisone in chloramphenicol-treated severe typhoid fever in Papua New Guinea

We investigated the effect of hydrocortisone on mortality and complications in chloramphenicol-treated severe typhoid fever (STF) in Goroka, Papua New Guinea. Of 374 culture-positive patients, 146 formed a retrospective comparison group, of whom 41 had STF. Of 228 patients in the intervention group, 58 had STF. Patients without STF had low mortality (2.5%) with standard treatment. In the intervention group, hydrocortisone was used in two dosage schedules, 100 mg for 12 doses (23 patients) and 400 mg for 12 doses (23 patients). There was no difference in mortality between steroid-treated and comparison STF patients (44.8% versus 43.9%) or in complications, and we conclude that moderate doses of steroids are not beneficial in severe typhoid fever.