{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:18:04Z","timestamp":1787771884888,"version":"build-2784847793"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>\n                      Drug-resistant typhoid fever is a major clinical problem globally. Emergence of multidrug-resistant (MDR)\n                      <jats:italic toggle=\"yes\">S. Typhi<\/jats:italic>\n                      has complicated therapy by limiting treatment options.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>A meta-analysis was planned to determine the strength of evidence supporting use of azithromycin over the alternate drugs available for treatment of uncomplicated typhoid fever.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Studies were identified using electronic database such as MEDLINE and other data at the National Library of Medicine assessed using PUBMED search engine as well as Cochrane Clinical Trial Register. Randomized control trials (RCTs) comparing azithromycin with chloramphenicol, fluoroquinolones and cephalosporins in culture-proven enteric fever were included. Data was extracted and methodological quality was assessed. Risk ratio (RR) with 95% confidence intervals was estimated for the dichotomous outcomes and mean difference (MD) with 95% confidence was estimated for continuous data. Primary outcomes studied were clinical failure (CF), microbiological failure, and relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of seven RCTs involving 773 patients met with our inclusion criteria. In comparison to older fluoroquinolones, azithromycin is marginally better in reducing the chance of CF with RR 0.46 (95% CI 0.25-0.82), while in comparison to ceftriaxone, it significantly reduced the chance of relapse with RR 0.1 (95% CI 0.01- 0.76). There were no serious adverse events reported in any of the trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Azithromycin can be recommended as a second-line drug in MDR typhoid fever, however, large trials involving pediatric age group patients are recommended to arrive at a definite conclusion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/0022-3859.97172","type":"journal-article","created":{"date-parts":[[2014,2,24]],"date-time":"2014-02-24T06:31:22Z","timestamp":1393223482000},"page":"112-118","source":"Crossref","is-referenced-by-count":29,"title":["A meta-analysis comparing the safety and efficacy of azithromycin over the alternate drugs used for treatment of uncomplicated enteric fever"],"prefix":"10.4103","volume":"58","author":[{"given":"NA","family":"Trivedi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"PC","family":"Shah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-4-20240205","first-page":"346","article-title":"The global burden of typhoid fever","volume":"82","author":"Crump","year":"2004","journal-title":"Bull World Health Organ"},{"key":"R2-4-20240205","doi-asserted-by":"crossref","first-page":"b1865","DOI":"10.1136\/bmj.b1865","article-title":"A comparison of fluoroquinolones versus other antibiotics for treating enteric fever: Meta-analysis","volume":"338","author":"Thaver","year":"2009","journal-title":"BMJ"},{"key":"R3-4-20240205","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1056\/NEJMra020201","article-title":"Typhoid fever","volume":"347","author":"Parry","year":"2002","journal-title":"N Engl J Med"},{"key":"R4-4-20240205","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.trstmh.2003.10.014","article-title":"The treatment of multidrug resistant and nalidixic acid resistant typhoid fever in Vietnam","volume":"98","author":"Parry","year":"2004","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"R5-4-20240205","first-page":"CD006083","article-title":"Azithromycin for treating uncomplicated typhoid and paratyphoid fever (enteric fever)","volume":"4","author":"Effa","year":"2008","journal-title":"Cochrane Database Syst Rev"},{"key":"R6-4-20240205","doi-asserted-by":"crossref","first-page":"223","DOI":"10.4103\/0255-0857.83904","article-title":"Antimicrobial resistance in typhoidal salmonellae","volume":"29","author":"Harish","year":"2011","journal-title":"Indian J Med Microbiol"},{"key":"R7-4-20240205","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1093\/jac\/37.suppl_C.45","article-title":"Concentrations of azithromycin in tonsilar and\/or adenoid tissue from paediatric patients","volume":"37","author":"Vaudaux","year":"1996","journal-title":"J Antimicrob Chemother"},{"key":"R8-4-20240205","first-page":"356","article-title":"Distribution of orally administered azithromycin in various blood compartments","volume":"32","author":"Wildfeuer","year":"1994","journal-title":"Int J Clin Pharmacol Ther"},{"key":"R9-4-20240205","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1128\/AAC.40.1.75","article-title":"Uptake of azithromycin by various cells and its intracellular activity under in vivo conditions","volume":"40","author":"Wildfeuer","year":"1996","journal-title":"Antimicrob Agents Chemother"},{"key":"R10-4-20240205","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1136\/bmj.323.7303.42","article-title":"Systematic reviews in health care: Assessing the quality of controlled clinical trials","volume":"323","author":"J\u00fcni","year":"2001","journal-title":"BMJ"},{"key":"R11-4-20240205","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/1471-2288-6-50","article-title":"Development and validation of MIX: Comprehensive free software for meta-analysis of causal research data","volume":"6","author":"Bax","year":"2006","journal-title":"BMC Med Res Methodol"},{"key":"R12-4-20240205","doi-asserted-by":"crossref","first-page":"b2535","DOI":"10.1136\/bmj.b2535","article-title":"PRISMA Group. 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