Comparative efficacy and safety of azithromycin monotherapy and azithromycin+cefixime combination therapy in uncomplicated typhoid fever

Background: Typhoid fever continues to occur on a large scale in countries where sanitation is suboptimal. For the last few years quinolones resistant strains of salmonella typhi are being reported. Now the third generation cephalosporins are being used as first line agent for typhoid fever .Since last few years various oral drug combinations have been tried and are available in Indian market for the treatment of typhoid fever. The present study was designed to evaluate the clinical efficacy, side effects and relapse rate of azithromycin monotherapy in uncomplicated typhoid fever cases as compared to those who were treated with azithromycin and cefixime combination therapy in standard dosage.Methods: 100 adult proven cases of typhoid fever of the age group of 16-65 years of either sex were included in the study. These patients were randomly divided into 2 groups of 50 patients each and then were followed up on and after treatment for 4 weeks. Group I: Patients were given oral azithromycin 500 mg twice daily for 7days. Group II: Patients were given oral Azithromycin 500 mg twice daily with oral cefixime 200 mg twice daily for 7 days.Results: No statistically significant difference was found in fever clearance time in two study groups. So both study groups were found comparable in terms of mean fever clearance time and clinical cure.Conclusions: Both mono and combination therapy could be equally effective oral therapy for typhoid fever. More studies have to be conducted in our scenario to reach a conclusion.