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document
A comparative study of ofloxacin and cefixime for treatment of typhoid fever in children . The Dong Nai Pediatric Center Typhoid Study Group . BACKGROUND Despite concerns about safety in children , fluoroquinolone antibiotics have become the treatment of choice in patients with multidrug-resistant typhoid fever in Vietnam . However , quinolone-resistant strains of Salmonella typhi have recently been reported from Vietnam ; and if quinolone resistance becomes established , alternative oral treatment options will be needed . OBJECTIVE Cefixime , an orally administered third generation cephalosporin , was compared with ofloxacin for the treatment of uncomplicated typhoid fever in children . METHODS In an open trial children with suspected typhoid fever were randomized to receive either ofloxacin ( 10 mg/kg/day in two divided doses ) for 5 days or cefixime ( 20 mg/kg/day in two divided doses ) for 7 days . RESULTS S. typhi was isolated from 82 patients ( 44 in the cefixime group , 38 in the ofloxacin group ) and 70 ( 85 % ) of the isolates were multidrug-resistant . Median ( 95 % confidence interval , range ) fever clearance times were 4.4 ( 4 to 5.2 , 0.2 to 9.9 ) days for ofloxacin recipients and 8.5 ( 4.2 to 9 , 1.8 to 15.2 ) days for cefixime-treated patients ( P < 0.0001 ) . There were 11 treatment failures ( 10 acute and one relapse ) in the cefixime group and 1 acute treatment failure in the ofloxacin group ( mean difference , 22 % ; 95 % confidence interval , 9 to 36 % ) . CONCLUSION Short course treatment with cefixime may provide a useful alternative treatment in cases of uncomplicated typhoid fever in children , but it is less effective than short course treatment with ofloxacin .
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Intervention_Pharmacological
ofloxacin
284
Intervention_Pharmacological
cefixime
285
Intervention_Pharmacological
fluoroquinolone antibiotics
286
Intervention_Pharmacological
Cefixime
287
Intervention_Pharmacological
cephalosporin
288
Intervention_Pharmacological
ofloxacin
289
Intervention_Pharmacological
ofloxacin
290
Intervention_Pharmacological
cefixime
291
Intervention_Pharmacological
cefixime
292
Intervention_Pharmacological
ofloxacin
293
Intervention_Pharmacological
ofloxacin
294
Intervention_Pharmacological
cefixime-treated
295
Intervention_Pharmacological
cefixime
296
Intervention_Pharmacological
ofloxacin
297
Intervention_Pharmacological
cefixime
298
Intervention_Pharmacological
ofloxacin
299
Outcome_Physical
fever clearance times
300
Outcome_Other
treatment failures
301
Outcome_Other
acute treatment failure
302
Participant_Condition
typhoid fever
303
Participant_Age
children
304
Participant_Condition
multidrug-resistant typhoid fever
305
Participant_Age
children
306
Participant_Condition
typhoid fever
307
Participant_Sample-size
82
308
Participant_Sample-size
70
309
Participant_Condition
uncomplicated typhoid fever
310
Participant_Age
children