Cefixime in the treatment of enteric fever in children

Area of Science:

• Pediatric Infectious Diseases
• Antimicrobial Therapy
• Clinical Pharmacology

Background:

• Salmonella typhi septicemia poses a significant health challenge, particularly in children.
• Increasing antimicrobial resistance to standard treatments like chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole necessitates alternative therapeutic options.
• Oral antibiotic formulations offer potential advantages in patient management and cost-effectiveness.

Purpose of the Study:

• To evaluate the efficacy and safety of oral Cefixime in treating Salmonella typhi septicemia in pediatric patients.
• To assess the treatment outcomes in children infected with multi-drug resistant S. typhi strains.

Main Methods:

• An open-label treatment trial involving 50 children diagnosed with S. typhi septicemia.
• Patients received oral Cefixime at a dose of 20 mg/kg/day, divided into two doses every 12 hours, for a minimum of 12 days.
• Clinical and bacteriological responses, fever resolution, relapse rates, and adverse events were monitored.

Main Results:

• All 50 patients achieved clinical and bacteriological cure.
• Fever subsided within an average of 5.3 days (range 3-8 days).
• Only two patients (4%) experienced relapse during the 8-week follow-up, and no serious adverse reactions were observed.

Conclusions:

• Oral Cefixime is an effective and safe treatment for S. typhi septicemia in children, even with multi-drug resistant strains.
• Cefixime offers a valuable therapeutic alternative to standard antibiotic regimens.
• The oral formulation of Cefixime presents an efficient alternative to parenteral therapy for less severely ill patients.