A Comparative Study of Efficacy and Safety of Azithromycin and Ofloxacin in Uncomplicated Typhoid Fever: A Randomised, Open Labelled Study

Chandey, Manish

doi:10.7860/jcdr/2012/4702.2631

Cited by 14 publications

(11 citation statements)

References 10 publications

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“…The dreaded complication of asymptomatic carrier state following enteric fever is more of adult concern and children are sort of protected from this state. This is also seen in our study wherein none of the children in both the groups had a positive fecal culture during the 4-week follow-up, which was similar to the observation made by Frenck et al, 5 Girgis et al, 12 and Chandey et al, 13 but contrary to that observed by Hussain et al 8 wherein a relapse rate of 5.33% was reported.…”

Section: Discussionsupporting

confidence: 91%

To Study the Effectiveness of Oral Azithromycin as Compared to Parenteral Ceftriaxone in the Treatment of Uncomplicated Enteric Fever

Nagaraj

Sivathanu

Manickam

et al. 2016

J Pediatr Infect Dis

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Aim?This study aims to compare the effectiveness of oral azithromycin and intravenous ceftriaxone in the treatment of uncomplicated enteric fever in children aged between 2 and 12 years. Methods?This prospective randomized open-labeled study was conducted in the Department of Pediatrics in a medical college of South India. A total of 126 children with proven enteric fever were randomized into two treatment groups. One group received oral azithromycin (20 mg/kg/d) and the other group received parenteral ceftriaxone (75 mg/kg/d), both of which were given for a duration of 7 days. The study population was observed for fever defervescence, duration of hospital stay, and relapse. Results?The mean time for fever defervescence was 3.68???2.109 and 4.08???1.903 days in the azithromycin group and the ceftriaxone group, respectively. The mean duration of hospital stay was 7.35???2.604 days in the azithromycin group and 9.44???0.249 days in the ceftriaxone group. In the azithromycin group three children had treatment failure and had to crossover to ceftriaxone group. Among the four treatment failures in the ceftriaxone group, two cases relapsed within 4-week follow-up period. There was no relapse in the azithromycin group. Conclusion?Oral azithromycin is as effective as intravenous ceftriaxone in treating uncomplicated typhoid fever in children with respect to fever defervescence, duration of hospital stay, and relapse.

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Section: Discussionsupporting

confidence: 91%

To Study the Effectiveness of Oral Azithromycin as Compared to Parenteral Ceftriaxone in the Treatment of Uncomplicated Enteric Fever

Nagaraj

Sivathanu

Manickam

et al. 2016

J Pediatr Infect Dis

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“…The drugs were concentrated intracellularly at the site of infection (484,485) and were rapidly bactericidal in vitro (481,486). When given for duration of 7 to 14 days, fluoroquinolones were often 100% effective with very low levels of relapse (329,342,443,470,(487)(488)(489)(490)(491)(492)(493)(494)(495)(496)(497)(498)(499)(500)(501)(502)(503)(504)(505). The clinical response was rapid, with fever resolution within 3 to 5 days.…”

Section: Fluoroquinolonesmentioning

confidence: 98%

Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections

et al. 2015

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SUMMARY Salmonella enterica infections are common causes of bloodstream infection in low-resource areas, where they may be difficult to distinguish from other febrile illnesses and may be associated with a high case fatality ratio. Microbiologic culture of blood or bone marrow remains the mainstay of laboratory diagnosis. Antimicrobial resistance has emerged in Salmonella enterica , initially to the traditional first-line drugs chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole. Decreased fluoroquinolone susceptibility and then fluoroquinolone resistance have developed in association with chromosomal mutations in the quinolone resistance-determining region of genes encoding DNA gyrase and topoisomerase IV and also by plasmid-mediated resistance mechanisms. Resistance to extended-spectrum cephalosporins has occurred more often in nontyphoidal than in typhoidal Salmonella strains. Azithromycin is effective for the management of uncomplicated typhoid fever and may serve as an alternative oral drug in areas where fluoroquinolone resistance is common. In 2013, CLSI lowered the ciprofloxacin susceptibility breakpoints to account for accumulating clinical, microbiologic, and pharmacokinetic-pharmacodynamic data suggesting that revision was needed for contemporary invasive Salmonella infections. Newly established CLSI guidelines for azithromycin and Salmonella enterica serovar Typhi were published in CLSI document M100 in 2015.

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“…In our study, 90.8% strains were sensitive similar to other reports. 24 It has negligible relapse rate and a favourable outpatient outcome, defervesence is rapid and represents potential alternative in paedetric population for whom quinolone are contraindicated. 26 Non availability of breakpoint concentration of azithromycin for Salmonella in most standard antibiotic guideline make the laboratory interpretation difficult.…”

Section: Discussionmentioning

confidence: 99%

“…[20][21][22][23] Several developing countries reporting emergence and spread of multidrug resistance (MDR) in S. enterica are busy in frantic search of effective and inexpensive alternative drugs to reduce the morbidity and mortality of enteric fever. 24 In 1948 chloramphenicol was introduced for the treatment of typhoid fever would reduce the duration of fever from 14-28 days to 3-5 days and mortality to 1%. Where chloramphenicol could not be used ampicillin and cotrimoxazole were used as alternative drug.…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial resistance pattern of Salmonella enterica servars in Southern Delhi

Tewari

Jamal

Dudeja

2015

Int J Community Med Public Health

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A Comparative Study of Efficacy and Safety of Azithromycin and Ofloxacin in Uncomplicated Typhoid Fever: A Randomised, Open Labelled Study

Abstract: Objective: To compare the efficacy and safety of azithromycin with ofloxacin in patients with uncomplicated typhoid fever.

Cited by 14 publications

References 10 publications

To Study the Effectiveness of Oral Azithromycin as Compared to Parenteral Ceftriaxone in the Treatment of Uncomplicated Enteric Fever

To Study the Effectiveness of Oral Azithromycin as Compared to Parenteral Ceftriaxone in the Treatment of Uncomplicated Enteric Fever

Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections

Antimicrobial resistance pattern of Salmonella enterica servars in Southern Delhi

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