Title: Efficacy and Safety of Azithromycin and Ofloxacin in Uncomplicated Typhoid Fever, in Tertiary Care Hospital at S.K.M.C.H., Muzaffarpur, Bihar
Authors: Dr Ashish Ranjan, Dr Deepak Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v7i5.04
Abstract
Objective: Present study was a Comparative Study and undertaken to know the Efficacy and Safety of Azithromycin and Ofloxacin in Uncomplicated Typhoid Fever.
Materials and Methods: A total of 120 Patients of either sex, aged between 20 and 55 with positive blood culture and Widal test for salmonella typhi along with clinical picture suggestive of typhoid fever were included in the study. All the patients were randomized in two study Groups. Group A included 60 patients, Group B also contains 60 patients. Group A patients received oral ofloxacin 200 mg twice daily for 7 days and Patients in Group B received oral Azithromycin 1 gm on day one and then 500 mg daily from day 2 to day 6. Written consent was taken from all the patients and all the data regarding age, occupation, clinical illness, past history of treatment were noted. All cases were followed up once weekly for a period of 4 weeks. All the cases came for follow up regularly and were examined for fever clearance time, cure rate and recurrence of symptoms of relapse.
Results: Out of 120 patients of typhoid fever 72 patients (60%) were male and 48 patients (40%) were females in the range of 20-55 years. After Ofloxacin treatment in Group A patients, 45(75%) patients showed good or moderate response while a 10 (16.66%) patient showed poor response and 5(8.34%) patients did not responded even after 7 days treatment and was considered treatment failure. Cure rate was found to be 80%. After Azithromycin treatment, all 60 patients (100%) showed good or moderate response and no poor response case was observed.
Conclusion: No significant difference in clinical cure rate was observed in two study groups. No relapse was recorded in the present study in a follow up period of 4 weeks in both study groups.
Kewwords: Enteric fever, Antibiotics, Ofloxacin, Cephalosporins. Azithromycin, Typhoid fever.
References
- Principles of Internal medicine by Harrisons 17 edition.
- Text book of Pharmacology K.D.Triphati.
- Text book of Microbiology Panikar
- Parry CM, Vinh H, Chinh NT, Wain J, Campbell JI, Hien TT, et al. The Influence of Reduced Susceptibility to Fluoroquinolones in Salmonella enterica Serovar Typhi on the Clinical Response to Ofloxacin Therapy. PLoS Neglected Tropical Diseases. 2011;5 (6): e1163.
- Lesser CF, Miller SI. Salmonellosis. In: Braunwald E, Fauci AS, Kasper DL, Hauser SL, Longo DL, Jameson JL, editors. Harrison’sPrinciples of Internal Medicine. 15th Edition. Vol. 1. New York: McGraw-Hill; 2001. pp. 971–73.
- Effa EE, Bukirwa H. Azithromycin for treating uncomplicated typhoid and paratyphoid fever (enteric fever) Cochrane Database of Systematic Reviews. 2008;(Issue 4) Art. No.: CD006083. DOI: 10.1002/14651858.CD006083.pub2.
- Bethell DB, Day NPJ, Nguyen MD, et al. Pharmacokinetics of oral and intravenous ofloxacin in multidrug-resistant typhoid fever. Antimicrob Agents Chemother. 1996;40:2167–72. (1996)
- Chau TT, Campbell JI, Galindo CM, Van Minh Hoang N, Diep TS, et al. Antimicrobial drug resistance of Salmonella enterica serovar typhi in Asia and molecular mechanism of reduced susceptibility to the fluoroquinolones. Antimicrob Agents Chemother. 2007;51:4315
- Crump JA, Kretsinger K, Gay K, Hoekstra RM, Vugia DJ, et al. Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreased susceptibility to fluoroquinolones: a United States foodnet multicenter retrospective cohort study. Antimicrob Agents Chemother. 2008; 52:1278–84.
- Joshi S, Amarnath SK. Fluoroquinolone resistance in Salmonella typhi and S. paratyphi A in Bangalore, India. Transactions of the Royal Society of Tropical Medicine and Hygiene. 2007;101(3):308–
- Chambers HF. Chloramphenicol, tetracyclines, macrolides, clindamycin, and streptogramins. In: Katzung BG, editor. Basic and Clinical Pharmacology. 9th Edition. Boston: McGraw Hill; 2004. pp. 754–63. [Google Scholar]