This site is intended for healthcare professionals

Go to /sign-in page

You can view 5 more pages before signing in


Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Seek expert advice:

  • azithromycin is increasingly used for the empirical treatment of enteric fever


  • for many decades, antibiotics such as chloramphenicol, ampicillin, and cotrimoxazole were used for treating enteric fever
    • emergence of multiple-drug-resistant (MDR) Salmonella strains, which are resistant to chloramphenicol, ampicillin, and cotrimoxazole, has changed treatment options (2)
      • second-line antibiotics like the fluoroquinolones (ciprofloxacin, ofloxacin, perfloxacin), third-generation cephalosporins (ceftriaxone, cefotaxime, cefixime), and azithromycin are often now used for treating MDR typhoid fever
        • infections with isolates susceptible to nalidixic acid (prototype fluoroquinolone) respond extremely well to fluoroquinolones
        • the extensive use of fluoroquinolones has since led to the emergence of intermediate and fully fluoroquinolone resistant strains

      • a systematic review concluded that (1):
        • azithromycin appears better than fluoroquinolone drugs in populations that included participants with drug-resistant strains
        • azithromycin may perform better than ceftriaxone

      • azithromycin is increasingly used for the empirical treatment of enteric fever
        • but widespread use of this drug in many parts of South Asia today may rapidly lead to development of resistance, highlighting the importance of good microbiological surveillance
        • some authors have advocated the addition of doxycycline for suspected enteric fever cases in regions of South Asia with high incidence of Rickettsia spp


Related pages

Create an account to add page annotations

Add information to this page that would be handy to have on hand during a consultation, such as a web address or phone number. This information will always be displayed when you visit this page