Q: My 32 years old wife is four months pregnant and has tested positive for typhoid. Her test results are S. typhi 'O'-positive at 1:60 dilution, S. typhi 'H'-positive at 1:240 dilution, S. paratyphi A 'H'-positive at 1:240 dilution, S. Paratyphi B 'H'-positive at 1:120 dilution. The doctor suggested Ceftum 500 mg but another doctor advised Cefi XL 200 mg. She has started with Cefi XL 200 mg but I am really worried whether the antibiotic she is taking won't have any adverse effect on our unborn child and as she has already been consuming Evion LC, will she need some additional vitamins? Also, she is having severe pain in her joints and the doctor advised Inflapen, which really relieves her pain. Can she continue taking the same antibiotics and Paracetamol?

A:I presume the blood test done was Widal. Unfortunately, over the years due to overuse and misuse of antibiotics, many typhoid germs have become resistant to drug therapy. Therefore ideally a blood culture should be done to identify bacteria and determine antibiotic sensitivity test and then give appropriate antibacterial agent. Ceftum (cefuroxime) and Cefi-XL (cefixime) have similar actions though Ceftum is more in vogue in the treatment of typhoid. It is not clear as to reasons for administering Evion LC (a fixed dose combination of vitamin E and l-carnitine). L-carnitine is given only when there is documented deficiency and more particularly in kidney dialysis patients. It has no role in pregnancy. The United States (Government) Food and Drugs Administration (USFDA) requires that manufacturers of l-carnitine must state that (a) this drug has not been tested in pregnant women and hence (b) should be given only when there is clear need due to deficiency. The only medicine required during pregnancy is folic acid. One must never take unnecessary untested drugs during pregnancy.