Typhoid Abdominalis: Drug Therapy

Therapeutic targets

  • Rehydration (fluid balance).
  • Elimination of pathogens
  • Avoidance of complications

Therapy recommendations

  • Antibiosis (antibiotic therapy) – Quinolones (gyrase inhibitors) are considered the gold standard in terms of the number of recurrences and persistent excretions. However, a third-generation cephalosporin such as ceftriaxone should now be used if patients are not from Africa. The reason is that, with the exception of Africa, in recent years, resistance to quinolones has increased very sharply worldwide.
  • Symptomatic therapy including fluid replacement – oral rehydration for signs of dehydration (fluid deficiency; > 3% weight loss): administration of oral rehydration solutions (ORL), which should be hypotonic, between meals (“tea breaks”) for mild to moderate dehydration.
  • If necessary, balance the electrolytes (blood salts).
  • Cave: Consider in shock the administration of dexamethasone (glucocorticoids) before antibiosis!
  • For continuous excretors: Ceftriaxone or ciprofloxacin; Salmonella permanent excretors may not work in food occupations!
  • See also under “Further therapy“.