A randomized comparison of oral chloramphenicol versus ofloxacin in the treatment of uncomplicated typhoid fever in Laos

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 99; no. 6; pp. 451 - 458
• Main Authors: Phongmany, Simmaly, Phetsouvanh, Rattanaphone, Sisouphone, Siho, Darasavath, Chirapha, Vongphachane, Pankham, Rattanavong, Oudayvone, Mayxay, Mayfong, Ramsay, Andrew C., Blacksell, Stuart D., Thammavong, Chanpheng, Syhavong, Bounkong, White, Nicholas J., Newton, Paul N.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.06.2005; Royal Society of Tropical Medicine and Hygiene; Elsevier
• Subjects: Administration, Oral; Adolescent; Adult; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - economics; Anti-Bacterial Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the digestive system and abdomen; Biological and medical sciences; Chloramphenicol; Chloramphenicol - administration & dosage; Chloramphenicol - economics; Clinical trial; Female; General aspects; Health Care Costs; Human bacterial diseases; Humans; Infectious diseases; Laos; Laos - epidemiology; Male; Medical sciences; Microbial Sensitivity Tests; Middle Aged; Ofloxacin; Ofloxacin - economics; Ofloxacin - therapeutic use; Prospective Studies; Salmonella Typhi; Time Factors; Treatment Outcome; Typhoid; Typhoid Fever - drug therapy; Typhoid Fever - epidemiology; Asia; Laos; Chloramphenicol; Clinical trial; Typhoid; Ofloxacin; Salmonella Typhi; Laos; Typhi; Salmonella typhi; Infection; Fluoroquinolone derivatives; Antibiotic; Chemotherapy; Treatment; Bacteriosis; Digestive diseases; Bacteria; Tropical medicine; Salmonellosis; Antibacterial agent; Quinolone derivatives; Comparative study; Enterobacteriaceae
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/j.trstmh.2004.08.007

We conducted a randomized open trial of oral chloramphenicol (50 mg/kg/day in four divided doses for 14 days) versus ofloxacin (15 mg/kg/day in two divided doses for 3 days) in 50 adults with culture-confirmed uncomplicated typhoid fever in Vientiane, Laos. Patients had been ill for a median (range) of 8 (2–30) days. All Salmonella enterica serotype typhi isolates were nalidixic acid-sensitive, four (8%) were chloramphenicol-resistant and three (6%) were multidrug-resistant. Median (range) fever clearance times were 90 (24–224) hours in the chloramphenicol group and 54 (6–93) hours in the ofloxacin group ( P < 0.001). One patient in the chloramphenicol group developed an ileal perforation. Three days ofloxacin was more effective than 14 days chloramphenicol for the in-patient treatment of typhoid fever, irrespective of antibiotic susceptibility, and was of similar cost.