Introduction: Typhoid fever, caused by Salmonella Typhi, remains a significant global health concern, particularly in regions with inadequate sanitation and water quality. The emergence of antibiotic-resistant strains poses challenges to effective management. This randomized controlled trial aims to compare the effectiveness of different antibiotic therapies in the treatment of typhoid fever, with a focus on clinical outcomes and antibiotic resistance patterns.

Methodology: A randomized controlled trial was conducted across diverse geographical regions with high typhoid incidence. Adult participants diagnosed with confirmed or suspected typhoid fever were randomly assigned to one of three antibiotic regimens: A) Ciprofloxacin and B) Azithromycin. Treatment duration and follow-up periods were standardized across groups. Clinical and microbiological data were collected throughout the study.

Results. Group A, treated with Ciprofloxacin, exhibited a marked and statistically significant decrease in symptoms, including a shorter duration of fever, reduced abdominal pain, and an overall decrease in illness severity. Clinical recovery rates were notably higher in Group A compared to Group B, which received Azithromycin. While Azithromycin also demonstrated efficacy in reducing symptoms, the magnitude of improvement was slightly lower than that observed in Group A. Microbiological assessments further revealed a notable difference in antibiotic resistance patterns between the groups, with Group A demonstrating lower rates of resistance compared to Group B. Despite the overall effectiveness of both treatments, the emergence of antibiotic resistance in certain cohorts highlights the ongoing challenge of antimicrobial resistance in typhoid fever management. These findings underscore the potential advantage of Ciprofloxacin in the treatment of typhoid fever and emphasize the need for continued research to address evolving resistance patterns and explore alternative treatment strategies.

Conclusion: In conclusion, randomized controlled trial comparing antibiotic therapies for typhoid fever highlighted the superior efficacy of Ciprofloxacin (Group A) over Azithromycin (Group B). Group A exhibited a significant and rapid reduction in symptoms, including fever duration and abdominal pain, emphasizing its potential as a preferred treatment option. The observed lower rates of antibiotic resistance in Group A further support its advantages in the context of antimicrobial stewardship. However, the emergence of resistance in both groups underscores the persistent challenge of antibiotic resistance in typhoid fever management. This study encourages a reconsideration of treatment guidelines, with a cautious approach toward Azithromycin. Future research should delve into alternative strategies and continue monitoring resistance patterns to optimize typhoid fever management.

Keywords

Typhoid, Infection, Fever, Antibiotics