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A comparative study of cefixime and chloramphenicol in children with typhoid fever
Insights
Cefixime demonstrated superior efficacy compared to chloramphenicol in treating childhood typhoid fever, achieving a 93.3% cure rate. This study highlights cefixime as a more effective antibiotic option for pediatric typhoid treatment.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial therapy
- Typhoid fever treatment
Background:
- Typhoid fever remains a significant public health concern in children.
- Chloramphenicol has been a traditional treatment but resistance is increasing.
- Novel therapeutic options are needed for effective typhoid fever management.
Purpose of the Study:
- To compare the clinical efficacy of cefixime versus chloramphenicol in children with culture-confirmed typhoid fever.
- To evaluate cefixime as a potential alternative treatment for pediatric typhoid.
Main Methods:
- A randomized controlled trial involving 40 children with culture-positive typhoid fever.
- Participants were assigned to receive either oral cefixime (10 mg/kg/day) or oral chloramphenicol (50 mg/kg/day) for 14 days.
- Clinical cure rates were assessed at the end of the treatment period.
Main Results:
- Cefixime achieved a clinical cure in 18 out of 20 children (90%), significantly higher than chloramphenicol's 9 out of 20 (45%).
- Ten of eleven children who failed chloramphenicol treatment were successfully cured after switching to cefixime.
- Overall, cefixime resulted in a cure rate of 93.3% (28/30) versus 45% for chloramphenicol (P = 0.0049).
Conclusions:
- Cefixime is significantly more effective than chloramphenicol for treating typhoid fever in children.
- Cefixime represents a valuable and effective therapeutic option for pediatric typhoid fever, especially in areas with potential chloramphenicol resistance.
Abstract:
We compared cefixime with chloramphenicol in a randomized trial for treatment of children with culture positive typhoid fever. Twenty children were given cefixime 10 mg/kg/day orally and twenty received chloramphenicol 50 mg/kg/day orally. On entry in the study, the clinical characteristics of the two groups were comparable. Duration of therapy was 14 days. Clinical cure was observed in 18 (90%) patients treated with cefixime and 9 (45%) treated with chloramphenical. Out of the 11 patients who did not respond to chloramphenicol, 10 were switched over to cefixime and all of them were cured. Over all 28 cases out of 30 (93.3%) P = 0.0049 were cured by cefixime.
