Troubling news from Asia about treating enteric fever: a coming storm


Edward T. Ryan


In The Lancet Infectious Diseases, Amit Arjyal and colleagues report the results from their randomised clinical trial comparing gatifloxacin with ceftriaxone for patients with uncomplicated enteric fever in Nepal. Their two main findings are sobering. First, they suggest that fluoroquinolones should no longer be recommended as front-line empirical treatment for individuals with enteric fever in Nepal. Second, a large proportion of individuals in Nepal who are syndromically characterised as having uncomplicated enteric fever probably have an alternative diagnosis.


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