A new and affordable drug, Gatifloxacin, may be more effective at treating typhoid fever than the drug currently recommended by the World Health Organization, according to research carried out in Nepal.

Typhoid fever is a major problem in developing countries, and drug-resistant strains are making it even more difficult to tackle. The best global estimates suggest at least 22 million cases of typhoid fever each year, leading to 200 000 deaths.

Now, clinical investigators led by Dr Buddha Basnyat at Patan Hospital in Lalitpur, Kathmandu, Nepal, together with the Oxford University Clinical Research Unit in Vietnam, have completed a study to compare the currently recommended treatment, Cefixime, with a new fluoroquinolone drug, Gatifloxacin. Cefixime is relatively expensive and must be administered for a longer duration than is ideal.

The results of the study show that Gatifloxacin may be a better treatment than Cefixime for enteric fever, of which typhoid fever is the most common form. There is currently no resistance to Gatifloxacin from Salmonella enterica Typhi and S. enterica serovar Paratyphi A, the two most common bacteria to cause enteric fever, unlike for other fluoroquinolones. At just over US$1 for a seven-day treatment course, the drug is also relatively inexpensive.

The research team hopes that the findings will improve treatment of patients with typhoid fever. Kathmandu, where Patan Hospital is located, is known as the typhoid capital of the world.

External links

• Pandit A et al. An open randomized comparison of gatifloxacin versus cefixime for the treatment of uncomplicated enteric fever. PLoS ONE 2007;2:e542.