Qasim Khan Khichi, Muhammad Saleem Channer.
Parenteral chloramphenicol versus chloramphenicol plus dexamethasone in the treatment of typhoid fever.
Pak Paed J Jan ;25(2):55-8.

This was an experimental student comprised of 175 cases admitted with clinical suspicion of typhoid fever. In addition to routine investigations, widal test, blood culture and bone marrow culture was done in those cases having history of fever for more than 15 days. Eighty four cases (48%) was included in the study. They were all widal positive as well as culture positive. Forty seven (55%) were resistant to conventional drugs like chloramphenicol, amoxicillin and septran. Six percent were resistant to third generation cephalosporins and 1% to ofloxacin in vitro. These 84 culture proven cases were randomly distributed into 2 groups – group A and group B to receive therapy with chloramphenicol 100mg/kg 24 hours in group A patients and chloramphenicol plus Inj. decadron 3mg/kg stat and then 1.5mg/kg iv every six hours. Defervescence was defined as a temperature of 37.5C after 48 hours of therapy. Children were kept in hospital until clearly stable. Each child was followed up for 12 weeks after cessation of therapy. Results: Time of defervescence is group A was 5+/-2.5d verus 24 hours in groups B. In group A, 22 cases (52.38%) responded in 5 days, 13 cases (30.95%) on 8th day of treatment and 6 cases (14%) failed to respond. In group B, 100% cases responded within 24 hours. Three cases (7.14%) restarted fever within 24 hours of stoppage of steroid therapy. Conclusion: Data suggest that parenteral chloramphenicol plus decadron is a better choice for treatment of typhoid fever.

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