Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever)

Fluoroquinolones for treating enteric fever

Emmanuel E Effa2, Zohra S Lassi1, Julia A Critchley3, Paul Garner4, David Sinclair4, Piero L Olliaro5, Zulfiqar A Bhutta1,*

Aga Khan University Hospital, Division of Women and Child Health, Karachi, Sindh, Pakistan
University of Calabar Teaching Hospital, Internal Medicine, Calabar, Cross River State, Nigeria
Newcastle University, Institute of Health and Society, Newcastle, Tyne and Wear, UK 
Liverpool School of Tropical Medicine, International Health Group, Liverpool, Merseyside, UK 
World Health Organization, UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR), Geneva, Switzerland

Effa EE, Lassi ZS, Critchley JA, Garner P, Sinclair D, Olliaro PL, Bhutta ZA. Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever). Cochrane Database of Systematic Reviews 2011, Issue 10. Art. No.: CD004530.

To read the full review please follow this link:  DOI: 10.1002/14651858.CD004530.pub4.

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.