Ciprofloxacin typhoid fever

The current drug of choice for typhoid fever is a fluoroquinolone, such as ciprofloxacin. The recommended dose of ciprofloxacin for uncomplicated typhoid is 500 mg orally twice daily for 5 to 7 days. Drug resistance is a recognized... 

Patients with complicated typhoid fever (i.e., metastatic foci, ileal perforation, etc.) should receive parenteral therapy with ciprofloxacin 400 mg twice daily or ceftriaxone 2000 mg once daily. Antimicrobial therapy can be completed with an oral agent after initial control of the symptoms of typhoid fever. In persons with AIDS and a first episode of Salmonella bacteremia, a longer duration of antibiotic therapy (1-2 weeks of parenteral therapy followed by 4 weeks of oral fluoroquinolone) is recommended to prevent relapse of bacteremia. 

Antibacterial treatment is generally not required in cases of gastroenteritis. Typhoid fever is treated with ciprofloxacin (quinolone), cefotaxime (third generation cephalosporin) or chloramphenicol. Impetigo necessitates the systemic use of flucloxacillin or erythromycin. Topical fusidic acid or mupirocin may also be used. 

Salmonella typhi Bacteremia paratyphoid fever typhoid fever Ceftriaxone, ciprofloxacin, or cefotaxime Trimethoprim-sulfamethoxazole... 

Typhoid fever is a generalised infection and requires treatment with ciprofloxacin. Chloramphenicol, amoxicillin or co-trimoxazole are less effective alternatives. The i.v. route should be used at... 

In 75 children with typhoid fever, aged under 6 years (mean age 32 months), ciprofloxacin had no adverse effects on growth or joints (54). In another study only 2 of 219 children treated with ciprofloxacin developed arthropathy, in one case transiently (55). In a necropsy study on children treated with ciprofloxacin 20 0 mg/kg/day for an average of 148 days, there were no chondrotoxic effects however, synovial membranes showed signs of subacute synovitis, which had not been noted in life (56). 

Doherty CP, Saha SK, Cntting WA. Typhoid fever, ciprofloxacin and growth in yonng children. Ann Trop Paediatr 2000 20(4) 297-303. 

Simpson J, Watson AR, Mellersh A, Nelson CS, Dodd K.Typhoid fever, ciprofloxacin, and renal failure. Archives of disease in childhood. 1991 Sep 66(9) 1083-4. 

Currently there are no commercially available vaccines for salmonellosis, but vaccines for typhoid fever are given to travelers going to countries with endemic disease. For most strains of Salmonella spp., antibiotics (specifically ampicillin, gentamicin, ciprofloxacin, and a combination of trimethoprim and sulfamethoxazole) are effective for both typhoid fever or severe salmonellosis some serotypes... 

The third-generation cephalosporins (e.g., ceftriaxone, ceflxime, cefotaxime, and cefoperazole) and azithromycin are also effective drugs for typhoid. Chloramphenicol, amoxicillin, and trimethoprim-sulfamethoxazole remain appropriate for the treatment of typhoid fever in areas of the world where the bacterium is still fully susceptible to these drugs and where the fluoroquinolones are not available or affordable. Although fluoroquinolones are not recommended in children, the pediatric use of ciprofloxacin in areas where multidrug-resistant S. typhi occurs is acceptable. In pregnant women, the p lactam antibiotics are safe, and there are some case reports to support fluoroquinolone use. 

Antibiotics indicated in the treatment of typhoid fever are ceftriaxone 1 g/kg M or IV b.i.d. and fluoroquinolones such as ciprofloxacin 500 mg PO b.i.d. or levofloxa-cin 500 mg or IV for 10-14 days. Fluroquinolones may be also administered in children. Chloramphenicol is still used but aplastic anemia is a consideration. Other antibiotics which are used depending on sensitivity are trimethoprin-sulfamethoxazole, amoxicillin, ampicillin, azithromycin and aztreonam. 

Ciprofloxacin is a fluoroquinolone antibiotic that interferes with microbial DNA synthesis. It is indicated in the treatment of infections of the lower respiratory tract, skin and skin structure, bones and joints, urinary tract gonorrhea, chancroid, and infectious diarrhea caused by susceptible strains of specific organisms typhoid fever uncomplicated cervical and urethral gonorrhea women with acute uncomplicated cystitis acute sinusitis nosocomial pneumonia chronic bacterial prostatitis complicated intra-abdominal infections reduction of incidence or progression of inhalational anthrax following exposure to aerosolized Bacillus anthracis. Cipro IV Used for empirical therapy for febrile neutropenic patients. 

Ciprofloxacin is recognized as a drug of first choice in the treatment of typhoid fever. 

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