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Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever): Cochrane systematic review

Summary

Fluoroquinolones for treating enteric fever
Researchers in The Cochrane Collaboration conducted a review of the effect of fluoroquinolone antibiotics in people enteric fever. After searching for relevant studies, they identified 26 studies involving 3033 patients. Their findings are summarized below.

What is enteric fever and how might fluoroquinolones work?

Enteric fever is a common term for two similar clinical illnesses known individually as typhoid fever and paratyphoid fever. These are most common in low- and middle-income countries where water and sanitation may be inadequate.

Enteric fever typically causes fever and headache with diarrhoea, constipation, abdominal pain, nausea and vomiting, or loss of appetite. In left untreated some people can develop serious complications and can be fatal.

The fluoroquinolones are a large family of antibiotic drugs, which are commonly used for a variety of infectious diseases. In the past, enteric fever responded extremely well to fluoroquinolones, but drug resistance has become a major public health problem in many areas especially Asia.

What the research says

Effect of using fluoroquinolones:

Generally, fluoroquinolones are effective in typhoid.

Policy makers and clinicians will need to consider local antibiotic resistance when considering treatment options for enteric fever.

One relatively new fluoroquinolone, gatifloxacin, seems to remain effective in some regions where resistance to older fluoroquinolones has developed.

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