Ghulam Mustafa.
Cefixime in treatment of Enteric Fever in children.
Pak Paed J Jan ;28(1):31-4.

Enteric fever is a serious health problem in Pakistan and the magnitude of the problem is on rise. The irrational use of drugs in its treatment is leading to the development of multidrug resistant strains. Therefore it is necessary to evaluate the local antibiotic sensitivities against S. typhi so as to keep the treatment options rational. To find out the safety & efficacy of cefixime, an oral, third generation cephalosporin, in our pediatric population, an open, prospective, treatment trial was undertaken on 54 children, less than 15 years of age, as outpatient cases. Cefixime (Cefim®) in a dose of 20 mg/kg/day, orally, divided into two dose, 12 hour apart, was administered for 10 days to the children with enteric fever. The treatment was changed to injectable third generation cephalosporins, if a child did not respond after 5 days of therapy. These children were followed up with stool culture at regular intervals till three months after therapy. Of these fifty (92.59%) responded to the therapy and were cured clinically. Fever subsided within a mean of 4.9 (range 3-7) days. Only four children (7.4%) had to be put on alternate therapy and only 4 relapsed during the follow up. At three months follow up, only 4 (7.4%) children had positive stool culture for S. typhi and so labeled as chronic carrier. No serious adverse reaction attributable to the drug was observed. Cefixime proved to be an effective and safe oral choice for the treatment of salmonella infection. The oral formulation provides an excellent alternative to parenteral therapy for outpatient children.

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