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Co-trimoxazole compared to chloramphenicol in the treatment of enteric fever
Abstract:
Co-trimoxazole (trimethoprim-sulphamethoxazole combination) was effective in the control of the acute infection in 60 patients with proven enteric fever. The mean interval between initiating treatment and defervescence was similar to that observed with a comparable group of 38 patients treated with chloramphenicol. Both co-trimoxazole and chloramphenicol were well tolerated and no serious adverse reactions, attributed to either drug, were noted. Two patients treated with chloramphenicol relapsed. No relapses were noted in the co-trimoxazole treated group. Although the evidence available at present in inadequate for drawing final conclusions regarding the relative efficacy of these two therapeutic agents in enteric fever, co-trimoxazole should be considered as an alternative drug, particularly when encountering salmonella strains resistant to chloramphenicol and ampicillin.
Insights
Co-trimoxazole effectively treated enteric fever, showing similar defervescence times to chloramphenicol. This antibiotic combination is a well-tolerated alternative, especially for resistant Salmonella strains.
Area of Science:
- Infectious Diseases
- Pharmacology
- Microbiology
Background:
- Enteric fever, primarily caused by Salmonella Typhi, remains a significant global health concern.
- Chloramphenicol has been a traditional treatment, but rising antimicrobial resistance necessitates alternative therapeutic options.
- Understanding the efficacy of alternative antibiotics like co-trimoxazole is crucial for effective disease management.
Purpose of the Study:
- To evaluate the efficacy and tolerability of co-trimoxazole (trimethoprim-sulphamethoxazole) in patients with acute enteric fever.
- To compare the treatment outcomes of co-trimoxazole with chloramphenicol in a controlled study.
- To assess the potential of co-trimoxazole as an alternative agent for enteric fever, particularly in cases of drug resistance.
Main Methods:
- A comparative study involving 60 patients treated with co-trimoxazole and 38 patients treated with chloramphenicol for proven enteric fever.
- Assessment of treatment effectiveness by monitoring the interval between initiating treatment and defervescence (fever resolution).
- Monitoring for adverse reactions and recording relapse rates in both treatment groups.
Main Results:
- Co-trimoxazole demonstrated effectiveness in controlling acute enteric fever infections.
- The mean time to defervescence was comparable between the co-trimoxazole and chloramphenicol treatment groups.
- Both co-trimoxazole and chloramphenicol were well-tolerated, with no serious adverse events reported for either drug.
- No relapses were observed in the co-trimoxazole group, whereas two relapses occurred in the chloramphenicol group.
Conclusions:
- Co-trimoxazole is an effective and well-tolerated treatment for acute enteric fever.
- Co-trimoxazole presents a viable alternative to chloramphenicol, especially when Salmonella strains exhibit resistance to chloramphenicol and ampicillin.
- Further research is warranted to definitively establish the relative efficacy of co-trimoxazole and chloramphenicol for enteric fever management.