Pediatric emergency medicine trisk 2387 2387

e-TABLE 94.18
TREATMENT OF TYPHOID FEVER
Disease type

Treatment

Uncomplicated with no
suspected resistance

Ciprofloxacin or ofloxacin
Adult:
500 mg twice daily po or IV for 7–10 days
Pediatric:
30 mg/kg/day (maximum dose: 1,000 mg po
or IV) for 7–10 days
Or Azithromycin
Adult:
1 g po × 1, then 500 mg po daily × 5–7 days
Pediatric:
10–20 mg/kg (max 1 g) po daily × 5–7 days
Azithromycin
Adult:
1 g po × 1, then 500 mg po daily × 5–7 days
Pediatric:
10–20 mg/kg (max 1 g) po daily × 5–7 days
Ceftriaxone or other third-generation
cephalosporin
Adult:
Ceftriaxone 2–3 g IV daily or cefixime 20
mg/kg/day divided twice daily for 7–14
days

Pediatric:
Ceftriaxone 100 mg/kg/day IV daily
(maximum: 4 g/day) or cefixime 20
mg/kg/day divided twice daily (maximum
dose: 400 mg/dose) × 10–14 days

Uncomplicated illness with
suspected or known
resistance

Severe illness a

a Bacteremia,

sepsis, meningitis, abscess, osteomyelitis, or in human immunodeficiency virus (HIV)infected patients, initial therapy with a parenteral third-generation cephalosporin should be initiated.
Aminoglycosides are not recommended for severe typhoid. The treatment duration for meningitis is 4 wks,
and 4–6 wks for osteomyelitis. Severe enteric fever, with shock and altered mentation, is an indication for
systemic corticosteroids–dexamethasone 3 mg/kg followed by 1 mg/kg every 6 hrs for a total course of 48
hors.