Treatment responses to Azithromycin and Ciprofloxacin in uncomplicated Salmonella Typhi infection: A comparison of Clinical and Microbiological Data from a Controlled Human Infection Model
PLOS Neglected Tropical Diseases·
- DOI
- 10.1371/journal.pntd.0007955
- PMID
- 31877141
- PMCID
- PMC6948818
- OpenAlex
- W2998150426
- Study type
- Randomised controlled trial
- Publisher
- Public Library of Science (PLoS)
- Article type
- journal-article
- Integrity
- current
Why this research matters now
The findings are relevant to first-line therapy of uncomplicated enteric fever in the context of emerging antimicrobial resistance, and motivate further work on azithromycin dosing regimens and combination strategies.
Structured evidence summary
Research question
The study compared clinical and microbiological treatment responses to azithromycin versus ciprofloxacin in uncomplicated Salmonella Typhi infection using a controlled human infection model.
Study design
An analysis of pooled data from two Salmonella controlled human infection studies in healthy UK adult volunteers: one single-centre open-label randomised trial (Study A) and one observational challenge/re-challenge study (Study B).
Population and setting
Healthy UK volunteers aged 18–60 years enrolled in two Salmonella controlled human infection studies, with 81 participants diagnosed with S. Typhi included in the treatment-response analysis.
Main findings
Azithromycin treatment was associated with prolonged bacteraemia compared with ciprofloxacin (median 90.8 hours vs 20.1 hours). The composite outcome of prolonged treatment response occurred more frequently with azithromycin than ciprofloxacin, with the abstract indicating this difference was statistically significant. The authors interpreted azithromycin as effective against fully sensitive strains but with delayed clinical response relative to ciprofloxacin.
Public-health relevance
The findings are relevant to first-line therapy of uncomplicated enteric fever in the context of emerging antimicrobial resistance, and motivate further work on azithromycin dosing regimens and combination strategies.
Important limitations
The summary is limited to the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation, including any additional methodological constraints of the human challenge model.
GIDS interpretation
This article is discoverable through GIDS classifiers under typhoid/paratyphoid fever, treatment, antimicrobial resistance, and vaccination topics, providing contextual background for surveillance-related queries; the abstract alone does not confirm any live surveillance signal.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 12 auditable classifier relationships to diseases, places, topics, and study design.