A randomized comparison of oral chloramphenicol versus ofloxacin in the treatment of uncomplicated typhoid fever in Laos


Simmaly Phongmanya, Rattanaphone Phetsouvanha, Siho Sisouphonea, Chirapha Darasavatha, Pankham Vongphachanea, Oudayvone Rattanavonga, Mayfong Mayxay, Andrew C. Ramsay, Stuart D. Blacksell, Chanpheng Thammavonga, Bounkong Syhavonga, Nicholas J. White and Paul N. Newton


We conducted a randomized open trial of oral chloramphenicol (50 mg/kg/day in four divided doses for 14 days) versus ofloxacin (15 mg/kg/day in two divided doses for 3 days) in 50 adults with culture-confirmed uncomplicated typhoid fever in Vientiane, Laos. Patients had been ill for a median (range) of 8 (2–30) days. All Salmonella enterica serotype typhi isolates were nalidixic acid-sensitive, four (8%) were chloramphenicol-resistant and three (6%) were multidrug-resistant. Median (range) fever clearance times were 90 (24–224) hours in the chloramphenicol group and 54 (6–93) hours in the ofloxacin group (P < 0.001). One patient in the chloramphenicol group developed an ileal perforation. Three days ofloxacin was more effective than 14 days chloramphenicol for the in-patient treatment of typhoid fever, irrespective of antibiotic susceptibility, and was of similar cost.


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