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A comparative study of cefixime and chloramphenicol in children with typhoid fever
M W Rabbani1, I Iqbal, M S Malik
1Department of Paediatrics, Nishtar Medical College, Multan.
Insights
Cefixime demonstrated superior efficacy in treating childhood typhoid fever compared to chloramphenicol. Most children unresponsive to chloramphenicol achieved clinical cure after switching to cefixime.
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.
- Alternative antibiotics 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 treatment outcomes and identify the most effective therapeutic option.
Main Methods:
- A randomized controlled trial involving 40 children with culture-positive typhoid fever.
- Group 1 received cefixime (10 mg/kg/day orally for 14 days).
- Group 2 received chloramphenicol (50 mg/kg/day orally for 14 days).
Main Results:
- Clinical cure rates were significantly higher with cefixime (90%) compared to chloramphenicol (45%).
- Ten out of eleven children who failed chloramphenicol treatment were successfully cured after switching to cefixime.
- Overall, cefixime achieved a 93.3% cure rate in 30 treated cases.
Conclusions:
- Cefixime is a highly effective antibiotic for treating childhood typhoid fever.
- Cefixime offers a superior alternative to chloramphenicol, especially in cases of suspected or confirmed resistance.
- Early switch to cefixime can improve treatment outcomes for non-responsive typhoid fever cases.
Abstract:
We compared cefixime with chloramphenicol in a trial for treatment of children with culture positive typhoid fever. Twenty children were given cefixime 10 mg/kg/day orally for 14 days and twenty received chloramphenicol 50 mg/kg/day orally for 14 days. On entry the clinical characteristics of the two groups were comparable. Clinical cure was observed in 18 (90%) patients treated with cefixime and 9 (45%) treated with chloramphenicol. Of 11 patients who did not respond to chloramphenicol, 10 were switched over to cefixime and all were cured. Overall 28 out of 30 cases (93.3%) were cured by cefixime.