How to effectively treat typhoid fever

Typhoid fever is relatively common in clinical practice. This disease is an acute intestinal infectious disease caused by Salmonella typhi. Patients may experience symptoms such as persistent high fever. As for the treatment of typhoid fever, it is generally based on drug treatment, and antibacterial drugs are mainly chosen to treat typhoid fever.

1. General treatment and symptomatic treatment

For patients with severe sepsis, hormones can be used in conjunction with sufficient and effective antibacterial treatment. Commonly used hydrocortisone 25-50 mg or dexamethasone 1-2 mg is slowly dripped intravenously once a day; or oral prednisone 5 mg is taken 3-4 times a day, and the course of treatment should not exceed 3 days.

If typhoid fever is combined with schistosomiasis, especially acute schistosomiasis, it is generally advisable to first use cortical hormones in combination with the treatment of the typhoid pathogen. Only after the body temperature is controlled and the general condition has improved significantly, oral praziquantel should be given to treat schistosomiasis. For patients with toxemia and significant bloating or diarrhea, the use of hormones should be cautious to avoid intestinal bleeding and intestinal perforation.

2. Choice of antimicrobial drugs for patients with typhoid fever

1. Fluoroquinolones are the first choice

2. Cephalosporins

Second and third generation cephalosporins have strong antibacterial activity against Salmonella typhi in vitro and low toxic and side effects. They are particularly suitable for pregnant women, children, lactating women and typhoid fever caused by chloramphenicol-resistant bacteria. Ceftriaxone is available, dosage: Adults

1g, once every 12 hours, children 100mg/kg per day, treatment course: 14 days. Ceftriaxone, dose: 1 to 2 g every 8 to 12 hours for adults, 100 to 150 mg per day for children

/kg, treatment course: 14 days.

3. Chloramphenicol dosage: 25 mg/kg per day, divided into 2 to 4 times orally or intravenously. After the body temperature returns to normal, the dose is halved. Treatment course: two weeks.

Treatment of carriers

1. Ampicillin

(or amoxicillin) Dosage: Adults: ampicillin 4-6g/day or amoxicillin 6g/day plus probenecid 2g/day, taken orally in 3-4 doses. Course of treatment: 6 weeks.

2. Ofloxacin or ciprofloxacin dosage: Ofloxacin 300 mg twice a day, ciprofloxacin 500-750 mg, orally twice a day, course of treatment: 6 weeks.

Treatment of complications

Intestinal perforation

Except for those with localized disease, patients with intestinal perforation accompanied by peritonitis should undergo early surgical treatment and use sufficient effective antibiotics, such as chloramphenicol or ampicillin combined with gentamicin or kanamycin, to control peritonitis.