Comparison of ciprofloxacin and co-trimoxazole on typhoid fever

Typhoid fever is a systemic infection caused by Salmonella typhi. The global emergence of multi-drug resistant (especially to ciprofloxacin) strains of this bacterium is of great concern. Therefore, the aim of this study was to compare the efficacy of co-trimoxazole with ciprofloxacin in empirical treatment of typhoid fever in outpatient cases from Ahvaz. In this clinical trial study, which was conducted in Ahvaz, 50 of outpatients were divided randomly into two groups. Group one were treated using ciprofloxacin (7.5mg/kg bid, 7 days) and the second one treated by co-trimoxazole (4.20mg/kg bid, 14 days). A blood sample taken from the patients before, at the end and 3 weeks after the treatment, and tested for S.typhi. The outcome of the treatment was regarded as responded (disconnection of fever and the culture became negative), failure to treatment, and relapse of the infection. These results were analyzed using SPSS11 software using t and Chi- Squared tests. The mean age of the patients in ciprofloxacin and co-trimaxazole groups were 22.4 and 22.1 years, respectively (p>0.05). The responses to the treatment (no fever, negative culture) with ciprofloxacin and co-trimoxazole were 81.81% and 78.57%, failure of treatment with ciprofloxacin and co-trimoxazole were 13.63% and 14.28% and relapse was 4.56% and 7.15%, respectively. This study showed that the effect of co-trimoxazole is similar to that of ciprofloxacin. Therefore, regarding the recent reports indicating increasing resistance of this bacterium to ciprofloxacin and limitation of using of it in children and pregnant women, we recommend co-trimoxazole for treatment of empirical typhoid fever.