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--- typhoid [2018/01/16 05:28] – created - external edit 127.0.0.1
+++ typhoid [2026/04/02 12:44] (current) – [ED Mx of suspected typhoid or paratyphoid enteric fever cases] wh
@@ Line 76: / Line 76: @@
   ***antibiotic Rx:**
     *reduced susceptibility to fluoroquinolones is common in infections acquired in the Indian subcontinent and South-East Asia. Initial therapy for infections from these regions should be with o azithromycin or iv ceftriaxone
-    *iv [[ceftriaxone]] 1g bd until clinical response adequate then change to oral azithromycin or ciprofloxacin for a further 7 days(([[http://etg.tg.org.au/ip/|Aust. Therapeutic Guidelines 2012]]))
+    *if outpatient Mx is appropriate and fever < 7 days duration, oral azithromycin 20mg/kg up to 1g 1st dose then daily for 10mg/kg up to 500mg daily for further 6 days ((ETG 2026))
-    *or, if outpatient Mx is appropriate and fever < 7 days duration, o azithromycin 20mg/kg up to 1g daily for 7 days
+    *for more unwell patients needing hospital care:
+      * if from pakistan:
+        * iv meropenem 1 g (child: 20 mg/kg up to 1 g) 8-hourly (adjust dose for renal function)
+        * or, iv azithromycin 1 g (child: 20 mg/kg up to 1 g)  as a single dose on day 1, followed by 500 mg (child: 10 mg/kg up to 500 mg) intravenously, daily
+      * otherwise from other countries:
+        *iv [[ceftriaxone]] 2g daily until clinical response adequate then change to oral azithromycin for a further 6 days
+        *or, iv azithromycin 1 g (child: 20 mg/kg up to 1 g) as a single dose on day 1, followed by 500 mg (child: 10 mg/kg up to 500 mg) intravenously, daily
   *iv fluids if dehydrated
   *admit to inpatient unit, single room