TREATMENT OF TYPHOID FEVER. I. COMBINED THERAPY WITH CORTISONE AND CHLORAMPHENICOL

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Abstract
Cortisone was employed in combination with chloramphenicol in 8 Malayan patients with typhoid fever. This combined therapy provided more prompt relief from the clinical manifestations of typhoid fever than did treatment with chloramphenicol alone. Earlier experience demonstrated that the chloramphenicol regimen required about 4 days before fever and toxemia disappeared. Typhoid patients who received 200 mg. of cortisone the 1st day and 100 mg. thereafter for several days in addition to chloramphenicol had an avg. febrile period of 50.2 hrs. Those who received 300 mg. of cortisone the 1st day, followed by decreasing amts. for the next 2 days along with chloramphenicol, were febrile for an avg. of 15.5 hrs. Chloramphenicol was administered to all 8 patients in 1.5 g. oral doses twice daily for 4-5 days, then once daily for 10 additional days. The combined therapy appears to be of sufficient theoretic and practical interest to warrant further study. Complications such as hemorrhage, perforation and relapse may still be expected in early convalescence. 2 of the present patients relapsed despite the 2-week course of chloramphenicol, and 1 continued to bleed for several days after he became afebrile.