Treatment of typhoid carriers with amoxicillin. Correlates of successful therapy
C. M. Nolan and P. C. White Jr
Fifteen chronic enteric carriers of Salmonella typhi were treated with
amoxicillin trihydrate, 2 g by mouth, three times per day. Nine of ten
patients who were able to take the full amoxicillin regimen were cured;
among five patients treated with a lower daily amoxicillin dosage because
of gastrointestinal (GI) side effects, only two were cured (P less than
.05). The mean serum amoxicillin concentration at termination of therapy
was higher (P less than .01) in five patients who were cured (10.4 +/- 1.6
microgram/ml) than in the four who failed (3.0 +/- 0.7 microgram/ml),
although the latter values were all above the minimal inhibitory
concentrations for infecting organisms. This study suggests that
amoxicillin treatment of chronic typhoid carriers could be enhanced by
treating with doses sufficient to provide suprainhibitory serum
concentrations of the antibiotic. However, GI intolerance to amoxicillin
could limit this therapeutic approach.
