Comparison of efficacy of azithromycin vs cefixime in the treatment of uncomplicated typhoid fever in children
DOI:
https://doi.org/10.61529/idjp.v34i2.400Abstract
Background: Typhoid fever is a serious infection caused by Salmonella Typhi, marked by prolonged fever and gastrointestinal symptoms. The aim of this study is to compare the clinical efficacy of 7day oral Azithromycin versus 14day Cefixime in treating uncomplicated typhoid fever in children.
Materials and method: This single-blind, randomized interventional study was conducted over one year (Dec 1, 2020–Nov 30, 2021) at Bacha Khan Medical Complex, Shahmansoor. Using non-probability consecutive sampling, 88 children with blood culture-confirmed uncomplicated typhoid fever (non-XDR Salmonella typhi) were enrolled and randomly divided into two groups (n=44). Group A received oral Azithromycin and Group B received oral Cefixime, with doses adjusted within the 10–20 mg/kg/day range for safety. Mean defervescence time was recorded, and relapse or recurrence was monitored for up to 3 months. Statistical analysis was done using the Chi-square test.
Results: Among 88 patients (mean age 7.4 ± 0.9 years), the average defervescence time was 5.00 ± 1.15 days for the cefixime group and 4.50 ± 1.11 days for the azithromycin group, with no significant difference (t=1.73, p=0.13). Relapse occurred in 22.7% of patients, significantly more in the cefixime group (34.1%) compared to azithromycin (11.4%) (χ²=20.389, p<0.001; p=0.019), indicating a statistically significant difference in relapse rates.
Conclusion: Azithromycin at 10-20 mg/kg/day for seven days was found to be as clinically effective as cefixime, with potential advantages in dosing convenience and cost, though statistical significance was not reached.
Keywords: Azithromycin, Cefixime, Efficacy, Typhoid fever
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