The Use of Azithromycin in Pediatric Typhoid Fever without Complication: A Case Report

Abstract

Typhoid fever is an infection caused by the bacterium Salmonella typhi. The prevalence is still high among emerging countries, such as Indonesia. There are limited options for the treatment of typhoid fever in children and more so is complicated by the emergence of antimicrobial resistance. The use of azithromycin has evolved as an important drug in the treatment of typhoid.   A male, aged 7 years and 2 months, was admitted to our hospital with remittent fever 4 days prior. The patient also presented with a period of cough since 2 days, and constipation, with full consciousness. The child had basic immunization completed for his age. He had a history of frequent consumption of street food. The diagnosis of typhoid fever was confirmed by serologic testing of positive 8 IgM Salmonella. Initially, the patient was treated with intravenous antibiotics of ceftriaxone for 8 days but shoed no clinical improvement, then the treatment was changed to intravenous azithromycin for 4 days and his condition improved greatly. The patient showed a better response with the use of azithromycin.   The management of typhoid fever remains challenging up to this day with variations in treatment response. From this case, we can conclude that azithromycin in some patients may show better improvement in the management of typhoid fever in pediatric patients. Although, ceftriaxone and other third-generation cephalosporins are still highly effective against Salmonella typhi.