Failure of short-course ceftriaxone chemotherapy for multidrug-resistant typhoid fever in children: a randomized controlled trial in Pakistan

The precise duration of therapy of multidrug-resistant (MDR) typhoid with b road-spectrum cephalosporins is uncertain. We prospectively randomized 57 c hildren with culture-proven MDR typhoid to receive treatment with intraveno us ceftriaxone (CRO) (65 mg/kg of body weight/day) for 7 days (short course ; n = 29) or 14 days (conventional; n = 28). The response to therapy, as ev aluated by the serial monitoring of the typhoid morbidity score and bacteri ological clearance, was comparable between groups. In contrast to the conve ntional therapy, 14% of the children receiving CRO for 7 days had a confirm ed bacteriological relapse within 4 weeks of stopping therapy.