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Typhoid Fever treatment

 Typhoid Fever treatment

thphoid-fever-treatment


Suspect when fever is high , continuous , lasting for over a week. Patient looks ill, with mild splenomegaly , relative bradycardia (no tachycardia), Leukopenia, and Wild test is positive.

Treatment 

  1. Bed rest.
  2. Small frequent feeds. Soft diet - Avoid chillies , spicy and oily foods. Maintain oral hygiene.
  3. IV. Ciplox 200 mg bd * 2-4 days, Then Tab. Ciplox 500 mg bd for 10-15 days (Ciprofloxacin) OR IV. Oflox 200 mg 12hrly * 2-4 days, then Tab. Oflox 500 mg bd for 10-15 days (Ofloxacin) OR IV. Chloromycetin 1 mg 6 hrly * 2-4 days, then cap. Chloromycetin 500 mg  6 hrly for 2 wks. (Chlor-amphenicol).
  4. Tab. Ultragin 6 hrly or S.O.S. when there is fever. (Paracetamol).
  5. Tab. Rantac 150 mg bd (Acid inhibitors).
  6. Tab. Wysolone 10 mg tds * 5 days, if the patient is toxic (Steroid ).
  7. Tab. Perinorm 1 tds - if there is vomiting (antiemetic)
  8. IV. Fluids - during acute phase, as and when necessary.
If there is no response after 4-5 days

Probably there is resistance to quinolones & Chloromycetin (MDR- Thphoid). So give third generation Cephalosporin. In some areas, doctors prefer it as the first line drug.

  1. Inj. Monocef 1 mg  IV bd to 6 hrly till fever is controlled / 6 days, then orally Tab. Cetil 500 mg 1-2 bd  for total 14 days. (Ceftriaxone). OR Tab. Cefi 400 mg 1 bd for 10-14 days. (Cefixime). OR Tab. Azee 1 gm od for 5 days.(Azithromycin). 
  2. Inj. Decadron 2 cc IV 12 hrly for 2-3 days.(Steroid).
In pregnant females, prefer third generation cephalosporin.

Prevention

Vaccinate all contacts in home, Also vaccinate people who eat hotel food & drink outside water frequently. 

  1. Oral Typhoral - one capsule on alternate days, on empty stomach in morning , 3 doses. With booster every 5 yrs. 
  2. Inj.Typhim vi 0.5 ml IM, Single Dose, Booster every 3 yrs. Better Protection then oral vaccine.

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