General
- Fluids and electrolytes may be given through a vein (intravenously)
- Drinking a lot of uncontaminated water with electrolyte packets.
Specific Treatment
Appropriate antibiotics are given to kill the bacteria. There are increasing rates of antibiotic resistance throughout the world, so your health care provider will check current recommendations before choosing an antibiotic. Several antibiotics are effective in enteric fever.
Ciprofloxacin in a dose of 500 mg 12-hourly is drug of choice. It is a fluroquinol Derivate
Adverse Drug Related events:
The most frequently reported drug related events were
- Nausea ii.Diarrhea iii. liver function tests abnormal
- vomiting v. rash
Alternative
- Alternative includes Co-trimoxazole (two tablets 400mg of sulpamethoxazole and 80 mg of trimethoprim) 12 hourly).
- Injection Co-trimoxazole I/M (intramuscular) ,5ml thrice
- Injection Co-TrimoxazoleIntravenous 10 ml diluted and infused twice daily
- Pediatrics suspension
- under six weeks not recommended
- 6 weeks to 5 month 2.5 m (all twice daily)
iii. Over 6 years -10ml (all twice daily)
Major adverse drug reaction of Co-trimoxazole is
- Stevens-Johnson syndrome, toxic
- Epidermal necrolysis
iii. Fulminant hepatic necrosis
- Agranulocytosis, aplastic anemia,
- Other blood dyscrasias
Resistance cases:
Increase in number of Salmonella, includes. S.typhi are now resistance to many antibiotics and some are only sensitive to Ciprofloxacin.
- a) The third generations under mentioned antibiotics are recommended when the organisms are resistance and the treatment to be continued for a period of fourteens days.:Cephalosporin. in a dose of 500 mg 12-hourly.
Adverse Reactions
- a) It should be administer with care to Pregnant and lactating mothers. b) Nausea, c) diarrhea , d) liver function tests abnormal, e) vomiting, f) rash
Ceftriaxone. Dosage; 1-2 g IV/IMqDay or divided BID for 4-14 days depend on type and severity of Infection. Use it with cautioned controlled study has shown no fetal risk. Allergic reactionscan be Difficulty breathing or Swelling of your face, lips, Tongue or throat
Cefotaxtime.
- Dosage: Mild to Moderate infection I/M,I/V 1-2 gms 8-12 hourly
- It should be administer with care to Pregnant and lactating mothers
Adverse drug Reaction:
Between 1-10 %
- Fever ii. Rash iii. Pruritus iv. Colitis v. Diarrhea
- Nausea vii. Vomiting viii. Eosinophilia ix. Inj site pain
Chronic Carrier:
In case there is recrudescence of the disease and development of the of a carrier should be treated for a period of 4 weeks with Ciprofloxacin; Cholecystectomy may be necessary in some cases.
Prevention of Typhoid
General Measures
- Water treatment
- Waste disposal
- Protecting the food supply from contamination are important public health measures
Specific Measures
- Carriers of typhoid must not be allowed to work as food handlers.
- Vaccines are recommended for travel outside
- During epidemic outbreaks.
- If you are traveling to an area where there is typhoid fever, you should bring electrolyte
- Packets in case you get sick.
- Immunization is not always completely effective and at-risk travelers should drink only boiled or bottled water
- Eat well-cooked food.
When to Contact a Medical Professional
- Call your health care provider if:
- You have had any known exposure to typhoid fever
- You have been in an endemic area and you develop symptoms of typhoid fever
- You have had typhoid fever and the symptoms return
- You develop severe abdominal pain, decreased urine output, or other new symptoms