Abstract
The study aims to assess the clinical efficacy of amoxycillin in comparison to cefixime in the treatment of childhood typhoid fever and to reduce morbidity and mortality from typhoid fever. This was an age and sex matched interventional study on inpatient and outpatients children of below 14 years of pediatrics department of Rangpur Medical College Hospital, Bangladesh from September 2013 to February 2014.A total 60 child diagnosed with typhoid fever was evaluated in this study. Male-female ratio was 1.31:1.0, most of them in between 1 to 5 years of age. Majority of patients (58.3%) were normal or mildly wasted. In most cases fever was continued (63.3%) in nature followed by intermittent (36.6%) in nature. Cure was achieved in amoxicillin and in cefixime group 73.3% and 83.3% respectively. Differences between two groups were not statistically significant. There was no significant difference between two groups in respect of cure rate and defervescence period. Also there was no serious adverse effect were found between two groups. Amoxycillin is effective and safe drug in the treatment of childhood enteric fever. Its efficacy is comparable with that of cefixime.
Keywords: Enteric fever, Typhoid fever, Oral drugs for enteric fever.
References
- Buckle GC, Walker CL, Black RE. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010. Journal of global health. 2012 Jun; 2(1).
- Naheed A, Ram PK, Brooks WA, Hossain MA, Parsons MB, Talukder KA, Mintz E, Luby S, Breiman RF. Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh. International Journal of Infectious Diseases. 2010 Sep 1; 14:e93-9.
- Health and Science Bulletin. ICDDRB, June2003, vol.1, No-3.
- Rahman AK, Ahmed M, Begum RS, Ghosh AK, Hossain MZ. Multidrug resistant typhoid fever in children: a review. Journal of Dhaka Medical College. 2008; 17(2):121-6.
- Khan M R, Hoque S S. Emergence of multidrug resistant S. Typhi: A need for therapeutic Reappraisal. Bangladesh J Child Health 1992; 16(1/2):1-3.
- Kalra SP, Naithani N, Mehta SR, Swamy AJ. Current trends in the management of typhoid fever. Medical Journal, Armed Forces India. 2003 Apr; 59(2):130.
- Rahman M, Siddique AK, Shoma S, Rashid H, Salam MA, Ahmed QS, et al. Emergence of multidrugresistant Salmonella enterica serotype Typhi with decreased ciprofloxacin susceptibility in Bangladesh. Epidemiol.Infect. 2006; 134: 433-438.
- Kabra SK. Multidrug-resistant typhoid fever. Trop Doct. 2000; 30(4):195–197
- Bhutta Z A, Khan I A, Molla A M. Therapy of multidrug resistant typhoid fever with oral cefixime VS Intravenous ceftriaxone. Pediatr Infect Dis J 1994; 13:990-994.
- Rahman M N. Clinical efficiency of ciprofloxacin in the treatment of childhood typhoid fever. Bangladesh J Child Health. 1995; 19(3):76-80.
- Mandal S, DebMandal M, Pal NK. Antibiotic resistance of Salmonella entericaserovarTyphi in Kolkata, India, and in vitro experiments on effect of combined chemotherapy. The Scientific World Journal. 2012 Jan 1; 2012.
- Crump JA, Mintz ED. Global trends in typhoid and paratyphoid fever. Clin Infect Dis. 2010; 50:241–246.
- Joshi S, Amarnath SK. Fluoroquinolone resistance in Salmonella typhi and S. paratyphiA in Bangalore, India. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2007 Mar 1; 101(3):308-10.
- Chaudhary MK, Rayamajhi BS, Paudel K, Bajracharya P, Chaudhary RS, Gyawali S. Efficacy of cefixime in the treatment of typhoid fever.International Journal of Pharmaceutical & Biological Archives 2013; 4(2): 307 – 309.
- Parry CM, Threlfall EJ. Antimicrobial resistance in typhoidal and nontyphoidal salmonellae. CurrOpin Infect Dis 2008; 21:531-8.
- Manchanda V, Bhalla P, Sethi M, Sharma V K. Treatment of enteric fever in children on the basis of current trends of antimicrobial susceptibility of Salmonella entericaserovartyphi and paratyphi A. Indian J Med Microbiol 2006;24:101-6.
- Sinha A. Typhoid fever in children age less than 5 years. Lancet 1999; 354:734-37.
- Malla T, Malla KK, Thapalia L A, Shaw C. Enteric fever: A retrospective 6 year analysis of 82 pediatric cases in a teaching hospital. Kathmandu Univ Med J 2007; 5:181-87.
- Singh SD, Shrestha S, Shrestha N, Manandhar S. Enteric fever in children at Dhulikhel Hospital. Journal of Nepal Paediatric Society. 2012; 32(3):216-20.
- Scragg J.N, Rubidge C.J. Amoxycillin in the treatment of typhoid fever in children. AM J trop Med Hyg. 1975; 24(5):860-65.
Corresponding Author
Dr Md. Nazmul Hassan
Department of Paediatric Gastroenterology & Nutrition,
Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
DOI: https://dx.doi.org/10.18535/jmscr/v9i3.32
