{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T01:36:24Z","timestamp":1791423384708,"version":"4.3.3"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"Supplement_1","license":[{"start":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T00:00:00Z","timestamp":1685664000000},"content-version":"vor","delay-in-days":32,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Joint Global Health Trials Scheme","award":["MR\/TOO5033\/1"],"award-info":[{"award-number":["MR\/TOO5033\/1"]}]},{"DOI":"10.13039\/501100000276","name":"Department of Health and Social Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000276","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002992","name":"Department for International Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002992","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016270","name":"Global Challenges Research Fund","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016270","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,6,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Patients with suspected enteric (typhoid and paratyphoid) fever are predominantly managed as outpatients in endemic regions. Nonspecific clinical presentation, lack of accurate diagnostic tools, and widespread antimicrobial resistance makes management challenging. Resistance has been described for all antimicrobials including chloramphenicol, amoxycillin, trimethoprim-sulfamethoxazole, ciprofloxacin, ceftriaxone, and azithromycin. No significant differences have been demonstrated between these antimicrobials in their ability to treat enteric fever in systematic reviews of randomized controlled trials (RCTs). Antimicrobial choice should be guided by local resistance patterns and national guidance. Extensively drug-resistant typhoid isolates require treatment with azithromycin and\/or meropenem. Combining antimicrobials that target intracellular and extracellular typhoid bacteria is a strategy being explored in the Azithromycin and Cefixime in Typhoid Fever (ACT-SA) RCT, in progress in South Asia. Alternative antimicrobials, such as the oral carbapenem, tebipenem, need clinical evaluation. There is a paucity of evidence to guide the antimicrobial management of chronic fecal carriers.<\/jats:p>","DOI":"10.1093\/ofid\/ofad179","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T17:30:37Z","timestamp":1685727037000},"page":"S26-S31","source":"Crossref","is-referenced-by-count":20,"title":["What Should We Be Recommending for the Treatment of Enteric Fever?"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7563-7282","authenticated-orcid":false,"given":"Christopher M","family":"Parry","sequence":"first","affiliation":[{"name":"Clinical Sciences, Liverpool School of Tropical Medicine , Liverpool , United Kingdom"},{"name":"Medical Microbiology, Alder Hey Children\u2019s Hospital , Liverpool , United Kingdom"},{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford , Oxford , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah N","family":"Qamar","sequence":"additional","affiliation":[{"name":"Department of Paediatrics and Child Health, Aga Khan University , Karachi , Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samita","family":"Rijal","sequence":"additional","affiliation":[{"name":"Oxford University Clinical Research Unit-Nepal , Kathmandu , Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naina","family":"McCann","sequence":"additional","affiliation":[{"name":"Hospital for Tropical Diseases, UCL , London , United Kingdom"},{"name":"Oxford Vaccine Group, Department of Paediatrics, University of Oxford , Oxford , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Baker","sequence":"additional","affiliation":[{"name":"Cambridge Institute of Therapeutic Immunology and Infectious Disease, Department of Medicine, University of Cambridge , Cambridge , United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Buddha","family":"Basnyat","sequence":"additional","affiliation":[{"name":"Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford , Oxford , United Kingdom"},{"name":"Oxford University Clinical Research Unit-Nepal , Kathmandu , Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,6,2]]},"reference":[{"key":"2023060210570587600_ofad179-B1","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1128\/CMR.00002-15","article-title":"Epidemiology, clinical presentation, laboratory diagnosis, antimicrobial resistance, and antimicrobial management of invasive Salmonella infections","volume":"28","author":"Crump","year":"2015","journal-title":"Clin Micro Rev"},{"key":"2023060210570587600_ofad179-B2","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/S1473-3099(18)30685-6","article-title":"The global burden of typhoid and paratyphoid fevers: a systematic analysis for the Global Burden of Disease Study 2017","volume":"19","author":"GBD 2017 Typhoid and Paratyphoid Collaborators","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"2023060210570587600_ofad179-B3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12916-019-1443-1","article-title":"Drug-resistant enteric fever worldwide, 1990 to 2018: a systematic review and meta-analysis","volume":"18","author":"Browne","year":"2020","journal-title":"BMC Med"},{"key":"2023060210570587600_ofad179-B4","article-title":"Clinical update: enteric fever","volume":"372","author":"Basnyat","year":"2021","journal-title":"BMJ"},{"key":"2023060210570587600_ofad179-B5","doi-asserted-by":"crossref","first-page":"S435","DOI":"10.1093\/cid\/ciz477","article-title":"Occurrence of typhoid fever complications and their relation to duration of illness preceding hospitalization: a systematic literature review and meta-analysis","volume":"69","author":"Cruz Espinoza","year":"2019","journal-title":"Clin Infect Dis"},{"key":"2023060210570587600_ofad179-B6","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1093\/cid\/ciy190","article-title":"Case fatality rate of enteric fever in endemic countries: a systematic review and meta-analysis","volume":"67","author":"Pieters","year":"2018","journal-title":"Clin Infect Dis"},{"key":"2023060210570587600_ofad179-B7","article-title":"Assessment and initial management of acute undifferentiated fever in tropical and subtropical regions","volume":"363","author":"Bhargava","year":"2018","journal-title":"BMJ"},{"key":"2023060210570587600_ofad179-B8","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1186\/s12941-016-0147-z","article-title":"What proportion of Salmonella Typhi cases are detected by blood culture? 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