Table 3.
|
Optimal treatment
|
Alternative effective treatment
|
|||||
|---|---|---|---|---|---|---|
| Susceptibility | Drug | Dailydose(mg/kg) | Course (days) | Drug | Daily dose(mg/kg) | Course (days) |
| Uncomplicated typhoid fever | ||||||
| Fully sensitive | Fluoroquinolone (such as ofloxacin or ciprofloxacin) | 15 | 5-7* | Chloramphenicol
|
50-75
|
14-21
|
| Amoxicillin
|
75-100
|
14
|
||||
| TMP-SMX | 8-40 | 14 | ||||
| Multidrug resistance
|
Fluoroquinolone or
|
15
|
5-7
|
Azithromycin
|
8-10
|
7
|
| Cefixime
|
15-20
|
7-14
|
Cefixime
|
15-20
|
7-14
|
|
| Quinolone resistance†
|
Azithromycin or
|
8-10
|
7
|
Cefixime | 20
|
7-14
|
| Ceftriaxone
|
75
|
10-14
|
|
|||
|
Severe typhoid fever requiring parenteral treatment
|
|
|
|
|
|
|
| Fully sensitive | Fluoroquinolone (such as ofloxacin) | 15 | 10-14 | Chloramphenicol
|
100 | 14-21 |
| Ampicillin
|
100 | 14 | ||||
| TMP-SMX | 8/40 | 14 | ||||
| Multidrug resistant
|
Fluoroquinolone | 15 | 10-14 | Ceftriaxone or
|
60
|
10-14
|
|
|
|
|
Cefotaxime
|
80
|
||
| Quinolone resistant
|
Ceftriaxone or
|
60
|
10-14
|
Fluoroquinolone | 20
|
14
|
| Cefotaxime | 80 | |||||
*
Three day courses also effective, particularly so in epidemic containment.
†
Optimum treatment for quinolone resistant typhoid fever has not been determined. Azithromycin, third generation cephalosporins, or a 10-14 day course of high dose fluoroquinolone is effective. Combinations of these are now being evaluated.