General approach to empirical therapy for typhoid and paratyphoid fevers

Empirical regimens in this topic are intended for use for patients:

• suspected to have typhoid or paratyphoid fever based on their clinical presentation
• in whom a Salmonella species has been identified in samples taken for blood culture, while awaiting typing and susceptibility testing.

Choice of empirical regimen for typhoid and paratyphoid fevers depends on the need for hospital admission. Patients should be managed in hospital if they have bacteraemia, are unable to tolerate oral therapy or have unstable vital signs. For empirical regimens, see:

• Adults and children 1 year and older who are well enough to be treated in the community
• Adults and children 1 month or older who require hospital admission, including those with sepsis and septic shock.

Typhoid and paratyphoid fevers are uncommon in neonates – seek expert advice.