Typhoid Fever: Azithromycin vs. Ceftriaxone for the Treatment of Mild to Moderate Cases in Children

Background: Typhoid fever is a bacterial infection that can spread throughout the body, affecting many organs. Without prompt treatment, it can cause serious complications and can be fatal. It's caused by a bacterium called Salmonella typhi, In areas where there are few carriers of the typhoid bacterium, the disease is uncommon. It's also unusual to find places with sanitary water treatment and waste management systems. Nowadays both Azithromycin and Ceftriaxone are used for the treatment of mild to moderate cases in children.

Objective: To assess the outcome of treatment of Acute Typhoid Fever with Azithromycin vs Ceftriaxone in Children with no other complication.

Methods: This comparative study was carried out at tertiary hospital from January 2019 to January 2020. Where 200 patients coming to the hospital were initially screened in the outpatient department. During the study period, all children 5-18 years of age who, according to the outpatient department physician, had a diagnosis of typhoid fever were admitted to hospital. After admission to the ward, Among 200 patients, 100 patients treated with azithromycin (7 days of 10 mg/kg/day (maximum dose, 500 mg/day) and 100 patients treated with ceftriaxone were cured (P > .05).

Results: During the study, majority belong to 5-10 years age group and 45% live in semipucca building followed by 60% drink Supply water without boiling and 80% cases were accustomed to solely home made food and outside of food. Clinical characteristics of azithromycin and ceftriaxone recipients who had typhoid fever and for whom blood cultures were positive where in azithromycin group mean duration of hospital stay was 9.8 days followed by 100 cases showed salmonella typhi positive.

Whereas in Ceftriaxone group mean duration of hospital stay was 9.0 days followed by 100 cases showed positivity in salmonella typhi positive. In azithromycin group 90% were cured by day 7 followed by 86% were cured microbiologically, plus no relapse cases were found.

Whereas in ceftriaxone case 80% were cured by day 7 followed by 78% were cured microbiologically, plus 5 relapse cases were found.

Conclusion: Oral azithromycin given once daily appears to be beneficial in the treatment of uncomplicated typhoid fever in children. If these findings are verified, the agent could be a viable therapeutic option for typhoid fever, especially in developing nations where medical resources are limited.