Can Typhoid Be Cured Completely? Gastroenterologist Explains.
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A complete cure for typhoid fever is difficult but not impossible. Salmonella bacteria that cause typhoid is becoming more resistant to antibiotics. However, you can be cured completely of typhoid if you take the right antibiotic for the right duration.
Failure of treatment of typhoid and recurrence of symptoms is common. About 5-10% of typhoid patients relapse after taking antibiotics (reference).
Moreover, ciprofloxacin (an effective medication against multi-drug resistant salmonella) is becoming less effective nowadays.
Some reports talk about more than 50% failure rates in the treatment of typhoid with ciprofloxacin (reference).
Today, your questions about the odds of treatment failure and complete recovery from typhoid. Also, you will learn about the most effective typhoid treatments.
More: Latest treatment of typhoid fever, gastroenterologist explains.
Why is a complete cure for typhoid difficult to achieve?
Back in the day, typhoid fever was treated by simple antibiotics such as:
- Amoxicillin.
- Trimethoprim-sulfamethoxazole.
- Chloramphenicol.
However, these treatments became completely useless nowadays. This is because of the development of multidrug-resistant (MDR) salmonella. Unfortunately, widespread MDR typhoid is now a global problem with a very high rate of treatment failure.
MDR typhoid is cured with antibiotics, mainly:
- Ciprofloxacin.
- Ceftriaxone (intravenous).
Unfortunately, A newly-emerged strain with even higher resistance to treatment is called the Extensively drug-resistant (EDR) typhoid. The EDR typhoid is even resistant to ciprofloxacin and ceftriaxone.
Both the MDR and the EDR strains of salmonella bacteria cause high rates of failed or incomplete cures.
Antibiotic resistance is the main cause of low rates of complete cure for typhoid fever.
What are the treatments that can achieve a complete cure for typhoid fever?
A good treatment that produces a complete cure for your typhoid fever depends on:
- The specific strains in your country and their resistance pattern.
- The culture and sensitivity tests.
- Adherence to the right dose for the recommended duration.
Work with your doctor to determine the best treatment for your typhoid fever.
After the emergence of Extensiviely-drug-resistant (EDR) typhoid, the options are limited.
The most important drug that is used in EDR typhoid is the Azithromycin antibiotic.
A large dose of Azithromycin (1 gm daily for 7 days) remains the most effective treatment for virulent typhoid strains.
However, the best treatment strategy is culture and sensitivity. The culture and sensitivity test defines the most effective antibiotic for your specific strain.
The below table illustrates the most commonly used antibiotics for typhoid fever and their doses (reference).
Adults | Children | Duration | |
Ciprofloxacin | Oral: 500 mg twice daily | Oral: 30 mg/kg per day in two divided doses (maximum 1000 mg per day)* | 7 to 10 days |
| IV: 400 mg twice daily | IV: 20 mg/kg per day in two divided doses (maximum 800 mg per day)* | ||
Ofloxacin | 400 mg orally or IV twice daily | 15 to 30 mg/kg per day orally in two divided doses (maximum 800 mg per day)*¶ based upon limited experience; optimal pediatric dose is not known | 7 to 10 days |
Ceftriaxone | 2 g IV once or twice daily | 50 to 100 mg/kg IV in one or two divided doses (maximum 4 g per day) | 10 to 14 days |
Cefotaxime | 1 to 2 g IV every six or eight hours | 150 to 200 mg/kg IV per day in three to four divided doses (maximum 8 g per day) | 10 to 14 days |
Cefixime | 200 mg orally twice daily | 20 mg/kg orally in two divided doses (maximum 400 mg per day) | 10 to 14 days |
Azithromycin | 1 g orally once, then 500 mg orally daily OR 1 g orally once daily | 10 to 20 mg/kg orally once per day (maximum 1000 mg per day) | 5 to 7 days |
Meropenem | 1 to 2 g IV every eight hours | 20 to 40 mg/kg every eight hours (maximum 6000 mg per day) | 10 to 14 days |
How is a complete typhoid cure confirmed?
In most cases, relapse of typhoid fever occurs one week after you stop taking the antibiotics. However, relapses can take up to 70 days or more to appear (reference).
The sure sign of cure from typhoid fever is remaining symptom-free for at least three months after treatment. The combination of the absence of symptoms for three months and negative culture of salmonella is considered a sure sign of recovery from typhoid fever.
The symptoms of relapse are essential the same as the primary disease. The most remarkable difference is that they’re milder (mainly fever, abdominal pain and fatigue).
- Evidence-based
- Written by a doctor.
