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Factors Influencing Fever Defervescence in Children with Enteric Fever

Niranjhana Raajasri1, Venkateswari Ramesh2, Sulochana Putli Bai Perumal3

  • 1Department of Pediatrics, Kanchi Kamakoti CHILDS Trust Hospital and CHILDS Trust Medical Research Foundation, Chennai, Tamil Nadu, 600034, India.

Indian Pediatrics
|May 12, 2026
PubMed

Insights

Fever from enteric fever is lasting longer. Factors like prior antibiotics and complications delay fever reduction, but children with Salmonella infections remain sensitive to ceftriaxone and azithromycin.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Enteric fever, caused by Salmonella Typhi or Paratyphi, is a significant global health concern.
  • Increasing duration of fever defervescence in enteric fever necessitates investigation into influencing factors.
  • Understanding treatment response is crucial for managing pediatric enteric fever cases.

Purpose of the Study:

  • To evaluate factors influencing fever defervescence in children with enteric fever.
  • To determine the minimum inhibitory concentrations (MICs) of ceftriaxone and azithromycin against Salmonella isolates.
  • To assess the current antibiotic susceptibility patterns for common enteric fever treatments.

Main Methods:

  • A study involving 150 children (1 month-18 years) with confirmed enteric fever.
  • Blood cultures were used for diagnosis (Salmonella Typhi or S. paratyphi).
  • Fever defervescence time, clinical factors, and antibiotic MICs were analyzed.

Main Results:

  • The median time to fever defervescence was 88 hours.
  • Prior antibiotic therapy, splenomegaly, and systemic complications were significantly linked to delayed fever defervescence.
  • All Salmonella isolates demonstrated sensitivity to ceftriaxone and azithromycin, with MICs below susceptibility breakpoints.

Conclusions:

  • Factors such as prior antibiotic use and complications prolong fever duration in pediatric enteric fever.
  • Ceftriaxone and azithromycin remain effective treatment options against current Salmonella Typhi and S. paratyphi strains.
  • Further research into optimizing treatment duration and managing complications in enteric fever is warranted.

Keywords:
AzithromycinCeftriaxoneMICSalmonellaTyphoid fever

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