From the Guidelines
Typhoid fever is not permanent and can be completely cured with appropriate antibiotic treatment. The standard treatment includes antibiotics such as ciprofloxacin, azithromycin, or ceftriaxone, depending on antibiotic resistance patterns in the region 1. According to the most recent guidelines, ceftriaxone is now preferred as a first-line agent for treating typhoid fever, especially in patients returned from Asia where there are increasing reports of fluoroquinolone-resistant isolates 1.
Treatment Options
- Ceftriaxone: 1-2 g daily for 10-14 days
- Azithromycin: 500 mg once daily for 7 days
- Ciprofloxacin: 500 mg twice daily for 7-10 days (although its use is limited due to resistance)
Without treatment, typhoid fever can persist for weeks or months and may lead to serious complications like intestinal perforation or bleeding 1. However, with proper medical care, most people recover completely within 2-4 weeks. After recovery, some individuals (about 2-5%) may become asymptomatic carriers, harboring the bacteria in their gallbladder and shedding it in their stool without showing symptoms 1.
Prevention and Carrier State
- Prevention through improved sanitation, safe drinking water, and typhoid vaccination is important, especially in endemic areas
- Asymptomatic carrier state can be addressed with prolonged antibiotic therapy or, in some cases, gallbladder removal
It's essential to note that the treatment and management of typhoid fever should be guided by the most recent and highest-quality evidence, and antibiotic resistance patterns should be considered when selecting treatment options 1.
From the Research
Typhoid Fever Overview
- Typhoid fever, also known as enteric fever, is a common cause of non-specific febrile infection in adults and children in low-resource settings such as South Asia 2.
- The disease is caused by Salmonella Typhi and Paratyphi bacteria, and its treatment is complicated by the emergence of antimicrobial resistance 3, 4.
Treatment of Typhoid Fever
- A 7-day course of a single oral antimicrobial such as ciprofloxacin, cefixime, or azithromycin is commonly used for the treatment of typhoid fever 2.
- Azithromycin and ciprofloxacin have been shown to be effective in treating typhoid fever, including cases with multidrug resistance 5, 6.
- Ceftriaxone is also an effective treatment option, especially in cases where other antibiotics are not effective due to resistance 3, 4.
Is Typhoid Fever Permanent?
- There is no evidence to suggest that typhoid fever is a permanent condition.
- With proper treatment, most people can recover from typhoid fever within a week or two 5, 6.
- However, if left untreated or if treatment is delayed, typhoid fever can lead to serious complications and even death 4.
Recurrence and Relapse
- Recurrence and relapse of typhoid fever can occur, especially if the treatment is not completed or if the bacteria are resistant to the antibiotic used 3, 6.
- A study found that azithromycin was associated with prolonged bacteraemia and fever clearance times compared to ciprofloxacin, which may increase the risk of recurrence and relapse 6.