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Trimethoprim and sulphamethoxazole in typhoid fever in children
Insights
Trimethoprim-sulfamethoxazole showed poor results for treating typhoid fever in children. Chloramphenicol remains the preferred treatment, though monitoring for blood changes is advised with trimethoprim-sulfamethoxazole.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Typhoid fever remains a significant global health concern, particularly in children.
- Antibiotic resistance necessitates ongoing evaluation of effective treatment options.
- Chloramphenicol has been a traditional treatment, but concerns about side effects exist.
Purpose of the Study:
- To compare the efficacy and safety of trimethoprim-sulfamethoxazole versus chloramphenicol in treating childhood typhoid fever.
- To assess the bacteriological response and identify potential adverse effects of trimethoprim-sulfamethoxazole.
Main Methods:
- A comparative study involving 103 children treated with trimethoprim-sulfamethoxazole and 40 children treated with chloramphenicol.
- Proved typhoid fever cases were included.
- Bacteriological response and haematological changes were monitored.
Main Results:
- Trimethoprim-sulfamethoxazole demonstrated an unsatisfactory bacteriological response in children with typhoid fever.
- Chloramphenicol treatment yielded better outcomes.
- Haematological changes were observed during trimethoprim-sulfamethoxazole therapy, necessitating monitoring.
Conclusions:
- Chloramphenicol is currently the treatment of choice for typhoid fever.
- Caution and blood picture monitoring are recommended when using trimethoprim-sulfamethoxazole due to potential haematological side effects.
Abstract:
One hundred and three children with proved typhoid fever were treated with trimethoprim-sulphamethoxazole, and the results compared with those of a further 40 children treated with chloramphenicol. The bacteriological response to trimethoprim-sulphamethoxazole was unsatisfactory. From this study it seems that at present chloramphenicol is still the treatment of choice for typhoid fever. In view of the haematological changes occurring during therapy with trimethoprim-sulphamethoxazole caution is necessary and monitoring of the blood picture advisable, even at the recommended dose.