Treatment responses to Azithromycin and Ciprofloxacin in uncomplicated < i > Salmonella < /i > Typhi infection: A comparison of Clinical and Microbiological Data from a Controlled Human Infection Model

by Celina Jin, Malick M. Gibani, Shaun H. Pennington, Xinxue Liu, Alison Ardrey, Ghaith Aljayyoussi, Maria Moore, Brian Angus, Christopher M. Parry, Giancarlo A. Biagini, Nicholas A. Feasey, Andrew J. Pollard BackgroundThe treatment of enteric fever is complicated by the emergence of antimicrobial resistantSalmonella Typhi. Azithromycin is commonly used for first-line treatment of uncomplicated enteric fever, but the response to treatment may be sub-optimal in some patient groups when compared with fluoroquinolones. MethodsWe performed an analysis of responses to treatment with azithromycin (500mg once-daily, 14 days) or ciprofloxacin (500mg twice-daily, 14 days) in healthy UK volunteers (18 –60 years) enrolled into twoSalmonella controlled human infection studies. Study A was a single-centre, open-label, randomised trial. Participants were randomised 1:1 to receive open-label oral ciprofloxacin or azithromycin, stratified by vaccine group (Vi-polysaccharide, Vi-conjugate or control Men-ACWY vaccine). Study B was an observational challenge/re-challenge study, where participants were randomised to challenge withSalmonella Typhi orSalmonella Paratyphi A. Outcome measures included fever clearance time, blood-culture clearance time and a composite measure of prolonged treatment response (persistent fever ≥38.0°C for ≥72 hours, persistently positiveS. Typhi blood cultures for ≥72 hours, or change in antibiotic treatment). Both trials are registered with ClinicalTrials.gov...
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research