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Dosage of chloramphenicol in typhoid and paratyphoid in children
Insights
A higher dose of chloramphenicol (100 mg/kg/24 h) significantly improved treatment success rates for pediatric salmonella enteric fever compared to a lower dose (50 mg/kg/24 h). This enhanced efficacy was observed with faster clinical responses in children with typhoid and paratyphoid.
Area of Science:
- Pediatric Infectious Diseases
- Pharmacology and Therapeutics
- Microbiology
Background:
- Salmonella enteric fever, including typhoid and paratyphoid, remains a significant public health concern in children.
- Chloramphenicol has been a historically important antibiotic for treating these infections, but optimal dosing strategies require further investigation.
- Treatment failures and the emergence of antimicrobial resistance necessitate a clear understanding of effective therapeutic regimens.
Purpose of the Study:
- To evaluate the efficacy of two different chloramphenicol dosage regimens in treating salmonella enteric fever in children.
- To compare treatment failure rates and time to clinical response between a lower and a higher dose of chloramphenicol.
- To provide evidence-based recommendations for chloramphenicol dosing in pediatric typhoid and paratyphoid cases.
Main Methods:
- A retrospective study analyzing data from 109 children treated for salmonella enteric fever over 12 years.
- Children were divided into two groups: Group A received 50 mg/kg/24 h of chloramphenicol, and Group B received 100 mg/kg/24 h.
- Treatment outcomes, including failure rates and time to clinical response, were compared between the two dosage groups.
Main Results:
- Treatment failure was significantly lower in the higher dose group (24%) compared to the lower dose group (63%) (P < 0.001).
- Children receiving the higher chloramphenicol dose experienced a faster clinical response, with a mean of 5.4 days compared to 7 days in the lower dose group (P < 0.01).
- The higher dosage regimen demonstrated superior efficacy in managing pediatric salmonella enteric fever.
Conclusions:
- An initial dose of 100 mg/kg/24 h of chloramphenicol is recommended for the effective treatment of typhoid and paratyphoid fever in children.
- Optimizing antibiotic dosage is crucial for improving treatment outcomes and potentially reducing the duration of illness in pediatric salmonella infections.
- Further research may explore long-term outcomes and resistance patterns associated with different chloramphenicol dosing strategies.
Abstract:
Over a period of 12 years, 109 children with salmonella enteric fever were treated with chloramphenicol: 65 children were given the drug at 50 mg/kg/24 h (Group A) and 44 received 100 mg/kg/24 h (Group B). Treatment failed in 63% with the lower dose and in 24% of children treated with the higher dose (P less than 0.001). In the children who received only chloramphenicol, the higher dose produced a clinical response in 5.4 (1.8) (mean (S.D.] days compared with 7 (2.6) days with the lower dose (P less than 0.01). Chloramphenicol in an initial dose of 100 mg/kg/24 h is recommended in the treatment of typhoid and paratyphoid in children.