From the Guidelines
For an uncomplicated typhoid (Salmonella Typhi infection) patient, the recommended dosage is ciprofloxacin 15 mg/kg twice daily for 7-10 days, as per the World Health Organization guidelines 1.
Key Considerations
- The dosage is based on the patient's weight, with a maximum dose not exceeding 500 mg per dose for ciprofloxacin.
- Alternative treatments include ceftriaxone IV or azithromycin oral, with dosages of 80 mg/kg daily for 5-7 days and 20 mg/kg daily for 5-7 days, respectively 1.
- It is essential to note that the choice of antibiotic and dosage may vary depending on the patient's age, weight, and potential resistance patterns.
Treatment Options
- Ciprofloxacin oral: 15 mg/kg twice daily for 7-10 days
- Ceftriaxone IV: 80 mg/kg daily for 5-7 days
- Azithromycin oral: 20 mg/kg daily for 5-7 days
Important Notes
- Adequate hydration and antipyretics like acetaminophen can be used to manage fever and symptoms during treatment.
- Patients should complete the full course of antibiotics even if symptoms improve before completion.
- Regular monitoring of clinical response is crucial, and if symptoms persist after 5 days of treatment, reassessment and possibly changing antibiotics may be necessary.
From the FDA Drug Label
DOSAGE AND ADMINISTRATION - ADULTS ... Typhoid Fever Mild/Moderate 500 mg q 12 h 10 Days The recommended dosage for an uncomplicated typhoid (Salmonella Typhi infection) patient is 500 mg every 12 hours for 10 days 2.
From the Research
Recommended Dosage for Uncomplicated Typhoid
- The recommended dosage for uncomplicated typhoid (Salmonella Typhi infection) varies depending on the antibiotic used:
- Azithromycin: 20mg/kg/day oral dose once daily (maximum 1gm/day) for 7-14 days 3, 4, 5, 6
- Ciprofloxacin: 500mg twice-daily for 14 days 3, or 20mg/kg of body weight/day for 14 days 6, or 500mg orally twice daily for 7-10 days 7
- Cefixime: 20mg/kg/day oral dose in two divided doses (maximum 400mg bd) for 7-14 days 5, 6
- Gatifloxacin: 10mg/kg/day oral dose once daily for 7 days 4
Treatment Outcomes
- Treatment outcomes for uncomplicated typhoid fever:
- Azithromycin: associated with prolonged bacteraemia and fever clearance times compared to ciprofloxacin 3, but showed excellent efficacy and safety profile in another study 4
- Ciprofloxacin: effective treatment for typhoid fever, with a clinical cure rate of 62% in one study 6
- Cefixime: showed a clinical cure rate of 71% in one study 6
- Gatifloxacin: showed excellent efficacy and safety profile, with a median fever clearance time similar to azithromycin 4
Combination Therapy
- Combination therapy with azithromycin and cefixime is being studied as a potential treatment option for uncomplicated typhoid fever, with the goal of limiting the emergence of resistance 5