Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
To the Editor.—We read with interest
the recent presentation and review of a case of Salmonella
typhiinfection in a pregnant woman returning from India. Dr Zenilman1discussed multidrug resistance (MDR) in S typhiand reinforced the general view that fluoroquinolones are effective
first-line therapy in the treatment of such infections.
We recently cared for a 52-year-old man who had arrived 1 week previously
from the Punjab region of northern India. He had had fever and headache for
6 days. Blood cultures grew S typhi,and he was treated
with oral ciprofloxacin (500 mg twice a day at presentation, increasing to
750 mg twice a day on day 3). Despite some clinical improvement he remained
febrile after 17 days of treatment. Ceftriaxone, 1 g once daily, was added
to his regimen, and his fever resolved within 3 days.
Atkins BL, Gottlieb T. Emerging Drug Resistance and Vaccination for Typhoid Fever. JAMA. 1998;279(8):579–580. doi:10.1001/jama.279.8.579