Therapeutic implications of ofloxacin in the treatment of typhoid fever caused by multiply resistant Salmonella typhi

The antibiotic of choice for the treatment of typhoid fever in most parts of the world is still chloramphenicol. Ampicillin and cotrimoxazole have been used in recent years. Selection of antimicrobials for therapy has been complicated by the emergence of Salmonella typhi strains resistant to the above mentioned antibiotics. Blood and/or bone marrow cultures of 30 adult patients grew S. typhi that was resistant to chloramphenicol, ampicillin and cotrimoxazole. However, these strains were sensitive to cefotaxime, ceftrioxone, aztreonam and ofloxacin. Ofloxacin 400 mg twice a day was given orally to these patients for 14 days. All patients recovered with no untoward side effect. We concluded that ofloxacin can be used as a drug of choice for typhoid fever, in those adult patients who are infected with S. typhi resistant to chloramphenicol, ampicillin and cotrimoxazole

Comparative yield of Salmonella typhi from blood and bone marrow cultures in patients with fever of unknown origin.

Over three years, a comparative study on 100 selected patients with fever of unknown origin was undertaken to determine the yield of Salmonella typhi from their blood and bone marrow cultures. The results indicate that in patients who had an infection with S typhi the organism was isolated from the bone marrow in all of them and from the blood in only 66%. This suggests that bone marrow cultures may be attempted when blood cultures are negative for bacterial growth after three to four days of incubation