Jeffry Adijaya Susatyo

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Typhoid fever is a disease caused by the gram-negative bacterium Salmonella typhi. Since its introduction in 1949, chloramphenicol has become the first-line treatment of typhoid fever for decades. Until now, chloramphenicol is still the first line treatment of typhoid fever in rural areas in Indonesia, due to its low cost. However, in addition to the problem of bacterial resistance, chloramphenicol is known to cause some side effect such as bone marrow suppression. Currently, many other antibiotics are used as the regimens for the treatment of typhoid fever, one of which is ceftriaxone. However, there are evidences on reemergence of chloramphenicol sensitivity in typhoid fever treatment. This report is created to answer the clinical question on whether ceftriaxone is more effective compared to chloramphenicol as the first-line treatment of typhoid fever. A structured search was performed on PubMed, EBSCO, and ScienceDirect and after a screening process and appraisal using the criteria from Center of Evidence Based Medicine at Oxford University, only one article was selected. The article shows higher efficacy of ceftriaxone in term of defervescence rate (P = 0.0001). No other study that compares the efficacy of ceftriaxone and chloramphenicol for typhoid fever treatment during the last ten years could be found during article searching. In conclusion, ceftriaxone shows better efficacy in the treatment of typhoid fever compared to chloramphenicol but with the rise of microbial sensitivity to chloramphenicol in recent years, more studies on this topic are needed to support this conclusion.


Typhoid fever; enteric fever; Ceftriaxone; Chloramphenicol; Effectiveness

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Lembaga Penyakit Tropis (Institute of Tropical Disease)

Universitas Airlangga

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