Cefoperazone compared with chloramphenicol in the treatment of typhoid fever

The authors have conducted an open randomized study to compare the clinical efficacy and safety of cefoperazone with those of chloramphenicol in the treatment of typhoid fever. They studied 56 subjects (28 in each group), 36 males and 20 females, whose average age was 25.9 years. The diagnosis of typhoid fever was made when one of the at least three blood cultures performed was positive for Salmonella typhi and in the presence of a 'toxic'-like symptomatology and hyperpyrexia (39 degrees C). Moreover, several stool cultures were done and the signs and symptoms characteristic of the pathology in progress were monitored. Furthermore, the MICs of cefoperazone and chloramphenicol were determined for all the strains of S. typhi isolated in both groups. Cefoperazone was given at the mean dose of 2 g i.v. every 8 h, and chloramphenicol at the dose of 500 mg by oral route every 6 h. The results obtained were assessed statistically (Friedman's test and Fischer's test). The authors conclude that cefoperazone is as active as chloramphenicol, and the importance of this result should not be underestimated.