Comparative efficacies of aztreonam and chloramphenicol in children with typhoid fever

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Abstract
We compared aztreonam with chloramphenicol in a randomized trial involving the treatment of 36 children with typhoid fever. Eighteen children were randomized to receive aztreonam, 150 mg/kg/day intravenously, and 18 to receive chloramphenicol, 100 mg/kg/day orally. On entry in the study the clinical characteristics of the two treatment groups were comparable. The duration of therapy was 14.9 .+-. 3.6 days for the aztreonam group and 12.8 .+-. 2.6 days for the chloramphenicol group. The mean duration of fever was 5.9 .+-. 3.1 days and 4.05 .+-. 2.1 days for aztreonam and chloramphenicol groups respectively (P > 0.05). Clinical cure was observed in all patients treated with aztrenam and in 17 of 18 children given chloramphenicol; one patient died in the latter group. There were no relapses in either group. We observed clinical adverse reactions during the treatment with aztreonam in 2 patients. All strains of Salmonella typhi were susceptible to aztrenam, 1 strain was resistant to chloramphenicol and 3 strains were resistant to ampicillin. Aztreonam appears to be a satisfactory alternative to chloramphenicol in cases of typhoid fever caused by resistant strains or when chloramphenicol is contraindicated.

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