How is typhoid fever treated?

Antibiotics: Antibiotic therapy is the only effective treatment for typhoid and paratyphoid fevers. In the past, the drug of choice was chloramphenicol (Chloromycetin®). Doctors no longer commonly use this antibiotic because of chloramphenicol's severe side effects, a high relapse rate, and widespread bacterial resistance. The existence of antibiotic-resistant bacteria is a serious and growing problem in the treatment of typhoid, especially in the developing world.

When bacteria prove resistant to standard antibiotics, illnesses last longer, and the risks of complications and death increase. Failure to treat an infection properly leads to longer periods in which an individual is contagious and able to spread the resistant strain to others. Because bacteria mutate much more quickly than researchers can develop new antibiotics, the possibility exists that one day highly lethal strains of resistant bacteria will evolve and doctors will have no effective way to treat them.

In the United States, most doctors now prescribe ciprofloxacin (Cipro) for adults other than pregnant women with typhoid fever. However, in some parts of the world, typhoid resistance has begun to extend even to ciprofloxacin. Women who are pregnant and children most often receive ceftriaxone (Rocephin) injections. All of these drugs can cause side effects, such as nausea and diarrhea, and long-term use can lead to the development of antibiotic-resistant strains of bacteria.

Other treatments: Other treatment steps aimed at managing symptoms include drinking plenty of fluids (called oral rehydration therapy) and eating a healthy diet, including plenty of fresh fruits and vegetables. Drinking fluids helps prevent the dehydration that results from a prolonged fever and diarrhea. If an individual is severely dehydrated, they may need to receive intravenous (IV, or into the veins) fluids. Non-bulky, high-calorie meals, such as those with rice or carbohydrates, can help replace the nutrients lost when the individual is sick with typhoid.

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