SHORT-COURSE CHEMOTHERAPY WITH CEFIXIME IN CHILDREN WITH MULTIDRUG-RESISTANT SALMONELLA-TYPHI SEPTICEMIA

Increasing prevalence of multidrug-resistant (MDR) Salmonella typhi st rains in pediatric cases of typhoid fever and chemotherapy restriction s in children, such as fluoroquinolones, require ongoing clinical eval uations of different antibiotic regimens. Previously reported clinical trials with oral cefixime therapy given as a 12-day regimen (20-30 mg /kg divided twice daily) demonstrated both safety and efficacy, An ope n trial was undertaken to investigate a short course (8-day) regimen o f oral cefixime in an Egyptian public fever hospital, Eighty children were initially enrolled with blood culture confirmation in 60 children , Clinical cure was documented in 57 (95 per cent) with three children requiring a change in antibiotic regimen due to therapeutic failure a nd one child with culture-confirmed relapsed 21 days post-therapy. All S. typhi isolates were sensitive to cefixime as measured by dish diff usion. Cefixime was well-tolerated with only mild side-effects, includ ing nausea/vomiting (8 per cent) and abdominal cramping with loose sto ols (6 per cent), which may have been secondary to typhoid fever. Cefi xime given in a short 8-day course is safe and effective in the manage ment of MDR typhoid fever in children.