A Single Blind Comparative Randomized Non-Inferior Multicenter Study for Efficacy and Safety of Levofloxacin versus Ciprofloxacin in the Treatment of Uncomplicated Typhoid Fever

Ronald Nelwan, Khie Chen Lie, Suharyo Hadisaputro, Eddy Suwandoyo, Suharto  , Nasronudin  , Hadi Yusuf, Primal Sudjana, Gatoet Ismanoe, Djoni Djunaedi, Halim Mubin, Munirah Said, Diana Paramita

Department of Internal Medicine, Persahabatan Hospital, Jakarta, Indonesia.
Divisions of Tropical & Infectious Diseases, Airlangga University, Surabaya, Indonesia.
Divisions of Tropical & Infectious Diseases, Diponegoro University, Semarang, Indonesia.
Divisions of Tropical & Infectious Diseases, Hasanudin University, Makassar, Indonesia.
Divisions of Tropical & Infectious Diseases, Padjajaran University, Bandung, Indonesia.
Divisions of Tropical & Infectious Diseases, University of Indonesia, Jakarta, Indonesia.

DOI: 10.4236/aim.2013.31019                

Abstract

Ciprofloxacin is currently the drug of choice for typhoid fever, but Salmonella typhi resistance to ciprofloxacin is increasing, while levofloxacin has been shown to be very effective in a few open studies. This study aimed to compare the efficacy, and safety of levofloxacin and ciprofloxacin for typhoid fever. From 110 patients with confirmed typhoid fever, 54 patients received oral levofloxacin 500 mg once daily with one drop out, while 56 received ciprofloxacin 500 mg twice daily for 7 days with two drop outs. Defervescence of fever was achieved on an average of 3 days after initiating levofloxacin and 5 days after starting ciprofloxacin and one microbiologically non confirmed typhoid fever relapse occurred in the levofloxacin group while two relapses with positive Salmonella microorganism occurred in the ciprofloxacin group. No carrier of Salmonella typhi was found in both groups at day 30. Adverse reactions were more pronounced in the ciprofloxacin group compared to the levofloxacin group. In conclusion, oral levofloxacin 500 mg once daily for one week showed faster fever clearance compared to ciprofloxacin 500 mg twice daily in typhoid fever in Indonesia, and less adverse reactions occurred with levofloxacin compared to ciprofloxacin. This electronic document is a “live” template. The various components of your paper (title, text, heads, etc.) are already defined on the style sheet, as illustrated by the portions given in this document.

Keywords

Typhoid Fever; Levofloxacin; Ciprofloxacin; Comparative Clinical Study; Indonesia

Conflicts of Interest

The authors declare no conflicts of interest.

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