Ciprofloxacin versus ceftriaxone in the treatment of multiresistant typhoid fever

M. R. Wallace*, A. A. Yousif, G. A. Mahroos, T. Mapes, John Threlfall, B. Rowe, K. C. Hyams

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

60 Citations (Scopus)


A randomized trial comparing ceftriaxone (3 g given parenterally per day for 7 days) to ciprofloxacin (500 mg given orally twice a day for 7 days) in the treatment of blood culture positive typhoid fever was conducted. Twenty patients were openly randomized to receive ciprofloxacin and 22 to receive ceftriaxone. The outcome was classified as clinical failure in 6 patients (27 %) in the ceftriaxone group, but in none in the ciprofloxacin group (p=0.01). The mean duration of fever was four days in the ciprofloxacin group and about five days in the ceftriaxone group (p=0.04). In the six patients in the ceftriaxone group who experienced failure, therapy was switched to ciprofloxacin and the patients became afebrile and asymptomatic within 48 hours. Patients with resistant strains of Salmonella typhi and patients with sensitive strains responded equally well to ciprofloxacin therapy. Analysis of a subset of 12 of the multiresistant strains revealed that resistance was encoded for by a transferable 180 kilobase plasmid. Ciprofloxacin represents a useful treatment option in areas where multiresistant strains are likely to be encountered.

Original languageEnglish
Pages (from-to)907-910
Number of pages4
JournalEuropean Journal of Clinical Microbiology and Infectious Diseases
Issue number12
Publication statusPublished - Dec 1993

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Copyright 2007 Elsevier B.V., All rights reserved.


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