Prospective randomized comparative trial of pefloxacin versus cotrimoxazole in the treatment of typhoid fever in adults

Hajji, M.; Mdaghri, N. El; Benbachir, M.; Filali, Kamal Marhoum El; Himmich, Hakima

doi:10.1007/bf01962337

Cited by 27 publications

(10 citation statements)

References 6 publications

(4 reference statements)

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“…Clinical and bacteriological results obtained in this trial confirm the excellent clinical effectiveness and safety of pefloxacin, already reported by ourselves and other authors [15,16] and of chloramphenicol in the therapy of typhoid fever. The differences registered between the two groups of patients regarding number of therapeutic successes, number of relapses during the follow up and number of chronic carriers at the end of therapy, even if very impressive, do not achieve statistical significance.…”

Section: Discussionsupporting

confidence: 88%

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Pefloxacin versus chloramphenicol in the therapy of typhoid fever

Cristiano¹,

Iovene²,

Imperatore³

et al. 1995

Infection

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An open, randomized clinical study was carried out to compare the clinical efficacy and safety of pefloxacin with that of chloramphenicol in the treatment of typhoid fever. Sixty hospitalized patients (40 men and 20 women, aged from 17 to 64 years), affected by severe proven typhoid sepsis, were randomly assigned to treatment with pefloxacin at a daily dose of 1,200 mg for 15 days (Group A) or with chloramphenicol at a daily dose of 2 g for 15 days (Group B). The two groups of patients were statistically homogeneous regarding both age and sex and all patients were followed for 30 days after the end of therapy. In Group A all the patients completely recovered from infection and all the isolated strains of Salmonella typhi were eradicated by pefloxacin treatment. In Group B two patients had a relapse, two patients became chronic enteric carriers of S. typhi and only 26 patients recovered from infection with complete eradication of the pathogen. The results indicate that pefloxacin is as active as chloramphenicol in the therapy of typhoid fever and that pefloxacin could be a valid antibacterial agent to be used together with appropriate hygienic measures for an eradication program of typhoid fever in the endemic countries.

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Section: Discussionsupporting

confidence: 88%

“…Hajjiet al in a preliminary clinical study [15] reported that 24 patients affected by typhoid fever were treated with pefloxacin 800 mg/day for 14 days. They recovered completely from infection without any clinical or bacteriological relapse and, after only 4 days of treatment, 62% of them were asymptomatic with negative blood cultures.…”

Section: Introductionmentioning

confidence: 99%

Pefloxacin versus chloramphenicol in the therapy of typhoid fever

Cristiano¹,

Iovene²,

Imperatore³

et al. 1995

Infection

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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: 99%

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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“…A number of studies, including one randomized, prospective trial, indicate that ciprofloxacin, ofloxacin and pefloxacin are all effective therapy for typhoid fever and do not result in chronic carriage of the organism (51)(52)(53)(54)(55)). An open trial showed that ciprofloxacin was successful in eliminating fecal excretion from ten of 12 chronic Salmonella typhi excreters, some of whom had excreted the organism for several years; all but two received 28 days of therapy (56).…”

Section: Salmonella In Tections and Chronic Excretion In Addition Tomentioning

confidence: 98%

Quinolones and the gastrointestinal tract

Murray¹

1989

Eur. J. Clin. Microbiol. Infect. Dis.

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A number of studies have evaluated the efficacy of the new fluoroquinolones for therapy of bacterial enteric diseases and for prevention of gram-negative sepsis in granulocytopenic patients. The success of the quinolones in these settings is related to several special features of these agents, including their spectrum of activity and high fecal levels, which are in turn reflected in their effect on the gastrointestinal flora. Other factors that are important, particularly for invasive disease such as typhoid fever and shigellosis, include good intracellular and bowel wall penetration, and lymph node and systemic drug concentrations many times higher than the MICs of the causative organisms. This article reviews the factors that contribute to the changes in fecal flora, and the results of clinical studies in patients with diarrhea, granulocytopenic patients, and patients with selected other infections of, or related to, the gastrointestinal tract.

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Prospective randomized comparative trial of pefloxacin versus cotrimoxazole in the treatment of typhoid fever in adults

Cited by 27 publications

References 6 publications

Pefloxacin versus chloramphenicol in the therapy of typhoid fever

Pefloxacin versus chloramphenicol in the therapy of typhoid fever

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

Quinolones and the gastrointestinal tract

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