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Treatment with ciprofloxacin in children with typhoid fever
1University Clinic of Paediatrics, Glostrup, Denmark.
Insights
Ciprofloxacin effectively treated typhoid and paratyphoid infections in children, with rapid fever reduction and no relapses. Adverse events were rare and temporary, showing ciprofloxacin
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Therapy
- Clinical Pharmacology
Background:
- Typhoid and paratyphoid fever remain significant childhood infections globally.
- Antibiotic resistance necessitates evaluating effective treatment options for these infections.
Purpose of the Study:
- To assess the efficacy, treatment outcomes, and safety of ciprofloxacin for childhood typhoid and paratyphoid infections.
- To evaluate ciprofloxacin's role in managing Salmonella infections in pediatric patients.
Main Methods:
- Retrospective analysis of 21 children treated with ciprofloxacin for culture-proven typhoid or paratyphoid fever (1991-1995).
- Data collected on treatment duration, dosage (oral and intravenous), clinical response, microbiological clearance, and adverse events.
Main Results:
- All Salmonella isolates were susceptible to ciprofloxacin.
- Median treatment duration was 10 days; median doses were 24 mg/kg/d orally and 15 mg/kg/d intravenously.
- All children achieved normal temperature within 4 days, with no clinical or microbiological relapses.
- Adverse events (transient ataxia, confusion) were rare and resolved without sequelae.
Conclusions:
- Ciprofloxacin demonstrated high efficacy and good tolerability in treating childhood typhoid and paratyphoid fever.
- The observed adverse events were infrequent, transient, and did not result in long-term complications.
- Ciprofloxacin is a safe and effective therapeutic option for pediatric Salmonella infections in this setting.
Abstract:
We investigated the use, treatment results and safety of ciprofloxacin in the treatment of childhood typhoid and paratyphoid infections in an industrialized country. The study was retrospective, and the material consisted of children admitted to Hvidovre or Glostrup University Hospitals from 1991 to 1995, and treated with ciprofloxacin for a culture proven diagnosis of typhoid fever. 21 children were included, 18 had positive cultures for Salmonella typhi and 3 had positive cultures for S. paratyphi A. All isolates were fully susceptible to ciprofloxacin. The median duration of treatment was 10 d, median oral dose was 24 mg/kg/d and the median intravenous dose was 15 mg/kg/d. Within 4 d after start of treatment all subjects had a normal body temperature. No subjects had clinical or microbiological relapse and all stool cultures after end of treatment were negative. Adverse events were rare, but in 2 children a transient limb/ataxia or a period of confusion were recorded. Both children recovered within a few days without sequelae. We conclude that ciprofloxacin was effective and well tolerated for treatment of typhoid fever in children. The few adverse events that were recorded left no permanent sequelae, and were likely to be caused by the disease itself.