Extensively drug-resistant typhoid or paratyphoid fever
For extensively drug-resistant (XDR) typhoid or paratyphoid fever, azithromycin or meropenem may be used depending on whether oral or intravenous therapy is required. In children younger than 1 year, intravenous therapy is always required. For neonates with typhoid or paratyphoid fever, seek expert advice.
In adults and children 1 year and older, if susceptibility is confirmed and oral therapy is appropriate, useNabarro, 2022:
azithromycin 1 g (child: 20 mg/kg up to 1 g) orally, as a single dose on day 1, followed by 500 mg (child 10 mg/kg up to 500 mg) orally, daily1. See advice on duration of therapy. azithromycin azithromycin azithromycin
In adults and children 1 month and older, if susceptibility is confirmed and intravenous therapy is required, useNabarro, 2022:
meropenem 1 g (child: 20 mg/kg up to 1 g) intravenously, 8-hourly. For dosage adjustment in adults with kidney impairment, see meropenem dosage adjustment. See advice on duration of therapy. meropenem meropenem meropenem