Comparing Gatifloxacin and Azithromycin for Typhoid Fever Treatment
Author Information
Author(s): Dolecek Christiane, Phi La Tran Thi, Rang Nguyen Ngoc, Phuong Le Thi, Vinh Ha, Tuan Phung Quoc, Cong Du Doan, Be Bay Nguyen Thi, Long Duong Thanh, Ha Luong Bich, Binh Nguyen Trung, Anh Hong Nguyen Thi, Dung Pham Ngoc, Lanh Mai Ngoc, Be Bay Phan Van, Ho Vo Anh, Van Minh Hoang Nguyen, Nga Tran Thu Thi, Chau Tran Thuy, Schultsz Constance, Dunstan Sarah J., Stepniewska Kasia, Campbell James Ian, Song Diep To, Basnyat Buddha, Vinh Chau Nguyen Van, Van Sach Nguyen, Chinh Nguyen Tran, Hien Tran Tinh, Farrar Jeremy
Primary Institution: Oxford University Clinical Research Unit, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
Hypothesis
Is gatifloxacin more effective than azithromycin for treating uncomplicated typhoid fever in Vietnam?
Conclusion
Both gatifloxacin and azithromycin are effective and safe for treating typhoid fever, especially in areas with high antibiotic resistance.
Supporting Evidence
- Both antibiotics showed an excellent efficacy and safety profile.
- Overall treatment failure was similar in both groups, with 9% in gatifloxacin and 9.3% in azithromycin.
- 96% of S. typhi isolates were resistant to nalidixic acid.
- The cost of gatifloxacin treatment is approximately one third of azithromycin in Vietnam.
Takeaway
This study tested two medicines to see which one works better for treating typhoid fever. Both medicines worked well, so doctors can use either one.
Methodology
A multi-center, open-label, randomized controlled trial comparing gatifloxacin and azithromycin over 7 days.
Limitations
The study had uneven numbers in treatment groups and low rates of stool cultures positive for S. typhi.
Participant Demographics
Median age was 11 years, with a range from 1 to 41 years; 75% were children under 15.
Statistical Information
P-Value
p=0.984 for fever clearance time comparison
Confidence Interval
95% CI; 94–118 hours for gatifloxacin versus 88–112 hours for azithromycin
Digital Object Identifier (DOI)
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