Antibiotic Therapy for Typhoid Fever in Children

Caussative agent: Salmonella typhi, S. Parathphi

Antibiotic therapy varies according to locations due to local resistance pattern

Malaysian NAG 2008 (peads)

Sarawak Handbook for Emergencies 3rd Ed (general)

*paeds dose based from FrankShann

Typhoid Management in Paeds 2006 (India)

International recommendations (general)

Recommendations:

1. based on the current practice and resistance pattern at our local settings, there is NO NEEDS for combination of antibiotic therapy yet
2. CIPROFLOXACIN is commonly used as first line therapy due to the ease of oral dosing. It is not Generally recommended for use in children and pregnant women because of observed potential/probable for causing cartilage damage in growing animals. However, there is now increasing data on safety and efficacy of quionolones in children
3. based on the practice and response in Sabah Hospitals (and sensitivity based on NAG 08), IV Ampicillin 50mg/kg QID followed by oral Amoxycillin 50mg/kg TDS (max 4.5g) can still be used. 

References:

1. Typhoid Fever Medications. http://emedicine.medscape.com/article/231135-medication
2. National Antibiotic Guidelines 2008
3. Sarawak Handbook for Emergencies 3rd Edition
4. www.uptodate.com