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How to treat typhoid fever?

Q: My daughter aged 7.5 yrs. is suffering from Typhoid as dignosed by the Widal Test (Salmonella typhi, O Antigen (TO) was found to be 1:80). However, the blood culture was sterile. My concern is that she is suffering from high fever of up to 102 till today. This problem started with fever on the evening of 12-10-02 which was controlled by Crocin. It again came up and was 103 so I consulted a Doctor who felt it was a viral fever and gave Nimulid for controlling. When the problem persisted for two days, I consulted another doctor on 16-10-02 who advised pathologigal tests like Widal, Hb, PS and blood culture along with routine urine examination. Only Widal test was found positive as stated earlier, and he started medication Zocin-100 and Syr. Fepanil 250 for fever from 17-10-02. According to him the typhoid fever will take 4-5 days to go. In the meanwhile she is still getting high fever upto 102. Since I am giving her Fepanil four hourly, the fever is not present for at least 3-4 hrs after giving medicine but after that it rises. I do not understand how long it will take. As per your article on typhoid, it takes minimum 5 days to go. But my daughter's typhoid is taking a long time. Is there anything abnormal in this case? Does typhoid takes such a long time to cure? Kindly advise

A:Your daughter's Typhoid may not be responding because we are now seeing in this country, infections by mdr Typhoid bacteria (multi drug resistant strains of Typhoid) which have emerged in the last few years because of the indiscriminate and overconsumption of antibiotics. Your daughter, who I presume weighs around 25 kg. at 7.5 yrs. may need a higher dose of Ofloxacin (200 mg. twice a day) , or addition of Cefixime, a third generation Cephalosporin at 20 mg/Kg/day in two divided doses for a total course of 14 days. My advice, in case your childs fever has not subsided, is to add on the second antibiotic, raise the dose of the first, and repeat a Widal test to check for a rising titre to Typhoid bacteria. Please consult a good Pediatrician in your neighbourhood, if you still have a problem.

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