Azithromycin versus Ceftriaxone for the Treatment of Uncomplicated Typhoid Fever in Children

A total of 108 children aged 4±17 years were randomized to receive 7 days of azithromycin (10 mg/kg/day; maximum, 500 mg/day) or ceftriaxone (75 mg/kg/day; maximum, 2.5 g/day), to assess the ef®cacy of the agents for the treatment of uncomplicated typhoid fever. Salmonella typhi was isolated from the initial cultures of blood samples from 64 patients. A total of 31 (91%) of the 34 patients treated with azithromycin and 29 (97%) of the 30 patients treated with ceftriaxone were cured (). All 64 isolates were susceptible to azithromycin andP 1.05 ceftriaxone. Of the patients treated with ceftriaxone, 4 subsequently had relapse of their infection. No serious side effects occurred in any study subject. Oral azithromycin administered once daily appears to be effective for the treatment of uncomplicated typhoid fever in children. If these results are con®rmed, the agent could be a convenient alternative for the treatment of typhoid fever, especially in individuals in developing countries where medical resources are scarce. Typhoid fever, a systemic infection caused by Salmonella ty-phi and Salmonella paratyphi, is a common and sometimes fatal infection among children living in developing countries, espe-cially such countries in Asia and Africa [1]. For decades, chlo-ramphenicol has been highly effective against S. typhi and S. paratyphi, and it often remains the antibiotic of choice for the treatment of typhoid fever [2, 3]. However, the widespread emergence of multidrug-resistant S. typhi has necessitated th