Randomized prospective study comparing two dosage regimens of ciprofloxacin for the treatment of typhoid fever

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Abstract
Sixty-two patients with blood culture-proven typhoid fever were randomly assigned to receive either 500 or 750 mg of ciprofloxacin orally, twice daily for 7 days or for two days following defervescence, whichever was greater. Thirty-four and 28 patients received 500 mg and 750 mg respectively. Strains of Salmonella typhi-resistant to ampicillin chloramphenicol and co-trimoxazole were isolated from the blood of 27 patients (43·5%). No resistance to ciprofloxacin was encountered. Both regimens were equally effective; fever subsided in mean times of 4·9±1·7 days in the 500 mg group and 5·2±2·days in the 750mg group (P = 0·54). All patients were cured, although one patient in the 750 mg group experienced a presumed relapse two months following completion of therapy. Ciprofloxacin administered for 7–10 days was adequate treatment for 57 of the 62 patients (92%); only five patients required therapy for more than 10 days. Patients with pretreatment symptoms of ≥ 10 days duration defervesced in a mean of 5·7±2·3 days compared with 4·5±1·3 days (P = 0·01) for those with symptoms of shorter duration. We conclude that 500 mg of ciprofloxacin taken orally twice daily is adequate treatment for typhoid fever.

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