Oral administration of fluoroquinolones in the treatment of typhoid fever and paratyphoid fever in Japan

Objective To study the adverse reactions and therapeutic effects of fluoroq uinolones to investigate whether they can be used for the treatment of pati ents with typhoid fever and paratyphoid fever. Methods The adverse reactions and therapeutic effects of fluoroquinolones w ere studied retrospectively in patients with typhoid fever and paratyphoid fever. Patients 58 patients (54 Japanese) with typhoid fever, 42 patients (41 Japa nese) with paratyphoid fever, and 1 Japanese patient with both typhoid feve r and paratyphoid fever, who were admitted in hospitals in Tokyo, Kawasaki, Yokohama, Kyoto, and Osaka from 1995 to 1998 and treated with fluoroquinol ones, Results Almost 80% of the patients were treated with tosufloxacin (TFLX) an d the remaining 20% were treated with norfloxacin, ciprofloxacin, levofloxa cin, or sparofloxacin, Side effects (nausea, urticaria, aphthous stomatitis ) and elevation of serum amylase were found in 3.6% and 8.3% of patients tr eated with TFLX, respectively, but these adverse reactions disappeared in a ll of these cases either with or without a change in the drug used. No adve rse reactions were found in patients treated with the other fluoroquinolone s. The clinical and bacteriological effects of these drugs were adequate. Conclusion Though further studies still need to be performed on the fluoroq uinolones other than TFLX, we can preliminarily conclude that fluoroquinolo nes are safe drugs and they can be recommended for the initial therapy of p atients with typhoid fever and paratyphoid fever.