FLEROXACIN VS CIPROFLOXACIN IN THE MANAGEMENT OF TYPHOID-FEVER - A RANDOMIZED, OPEN, COMPARATIVE-STUDY IN NIGERIAN PATIENTS

Objective: The antibacterial efficacy of fleroxacin was compared with that of ciprofloxacin in 72 adult Nigerian patients with typhoid fever . Patients and Methods: On inclusion into the study, patients were ran domised to treatment with either fleroxacin 400mg once daily for 7 day s or ciprofloxacin 500mg twice daily for 14 days. Clinical evaluations were performed on days 0, 1, 2, 3, 5 and 7 or 14, and 2 weeks after t reatment. Bacteriology was performed on days 0, 3, 7 or 14, and 21 or 28. Laboratory tolerability parameters were monitored for all patients as well as incidence of adverse events. Results: Bacteriological resp onse on day 3 was 93.5 and 64.0% for fleroxacin and ciprofloxacin, res pectively. At term and follow-up there was bacteriological cure in 97. 0% of patients with fleroxacin and 100% with ciprofloxacin. The clinic al cure was 100% for both groups at term. The incidence of adverse eve nts was 5.4% with fleroxacin and 2.8% with ciprofloxacin. Conclusion: The results demonstrated that while the clinical response rate with bo th drugs was comparable, fleroxacin exhibited a faster bacteriological clearance rate. We therefore concluded that 7 days' therapy with fler oxacin 400mg once daily was as effective as 14 days' therapy with cipr ofloxacin 500mg given twice daily in the management of typhoid fever i n Nigerian patients. It was also observed that the quinolones possesse d greater potential and benefits as first-line therapy for the managem ent of typhoid fever in this environment. The tolerability profile was good for both treatment regimens.