International Journal of Medicine and Medical Science Research  Vol. 2(5), pp. 058-063, September 2014 ©2014 Academe Research Journals

Full Length Research Paper

Efficacy, safety and tolerability of levofloxacin versus ciprofloxacin in complicated typhoid fever

Suharyo Hadisaputro¹*, S Suharto², RHH Nelwan³, Hadi Yusuf⁴, Primal Sudjana⁴, Muchlis Achsan Udji Safro¹, Erwin Asta², Gatoet Ismanoe⁵, Djoni Djunaedi⁵, Halim Mubin⁶ and La Ode Wahid⁶

¹Division of Tropical and Infectious Disease, Department of Internal Medicine, University of Diponegoro Semarang, Indonesia.

²University of Airlangga, Surabaya, Indonesia.

³University of Indonesia, Jakarta, Indonesia.

⁴University of Padjadjaran, Bandung, Indonesia.

⁵University of Brawidjaya, Malang, Indonesia.

⁶University of Hasanudin, Makasar, Indonesia.

*Corresponding author. E-mail: felisiasantoso@yahoo.com.

Accepted 7 August, 2014

Abstract

In this study, 137 patients treated for complicated typhoid fever were randomized to either intravenous levofloxacin 500 mg once daily (OD), which then switched to sequential oral 500 mg levofloxacin, or intravenous ciprofloxacin 400 mg twice daily (BID), which then switched to oral ciprofloxacin 500 mg BID in the same course of 10 days. Resolution of fever occurred on the average after 3.47 days of treatment in the levofloxacin group and 4.08 days of treatment in the ciprofloxacin group. A significant difference was obtained between the two groups. In both groups, there were cases of clinical relapse after typhoid fever treatment; one case (2%) in the levofloxacin group and three cases (4%) in the ciprofloxacin group. During treatment, one or more adverse events were reported in 8 out of 69 (11.6%) patients in the levofloxacin group as compared to 21 out of 68 (30.1%) patients in the ciprofloxacin group. Post treatment stool examination detected no carrier state in both groups of study. Compared to ciprofloxacin, levofloxacin 500 mg daily, administered intravenously which then switched orally, for complicated typhoid fever, showed better clinical as well as laboratory outcomes and less occurrence of adverse reactions.

Key words: Ciprofloxacin, levofloxacin, complicated typhoid fever.