The Outcome of Azithromycin and Ciprofloxacin for Treatment of Uncomplicated Typhoid Fever

Abstract

Background: Enteric fever affects more than 11 million children and adults globally each year. Typhoid fever is treated with antibiotics. Ideally, treatment should be safe and available for adults and children in shortened courses of 5 days, cause defervescence within 1 week, render blood and stool cultures sterile, and prevent relapse. Objective: To compare the outcome of azithromycin and ciprofloxacin for treatment of uncomplicated typhoid fever. Method: This comparative intervention was done at tertiary hospital where one hundred patients ranging in age from 5 to 25 years were enrolled in the study and randomly assigned to one of the two treatment groups. Group A constituted of 50 patients receiving azithromycin and group B constituted of the other 50 patients receiving ciprofloxacin. All patients underwent blood cultures or stool cultures from which S. typhi or S. paratyphi was isolated, and these subjects comprised the basis for analysis. Results: During the study, majority of the patients belonged to 5-15 years age group. 50% cases lived in semi pucca buildings followed by 70% drank supply water without boiling and 80% cases were accustomed to homemade food and outside food. Moreover, significance association was noticed in food habit and water source of the patients. In group A, 50 cases showed positivity in salmonella typhi and their mean duration of hospital stay was 10 days. Similarly, in group B, 50 cases showed positivity in salmonella typhi and mean duration of hospital stay was 9.0 days. In group A, 90% were cured by day 7 plus no relapse cases were found. In group B, 80% were cured by day 7. Mild-to- moderate adverse events, all of which were short-term and self-limited were reported equally in both treatment groups. Conclusion: Our results indicated that azithromycin and ciprofloxacin were similarly effective, both clinically and bacteriologically, against typhoid fever caused by both sensitive organisms and MDR S. typhi.