Tifoda Chloramphenicol Tedavisi ve Kifayetsiz Tedavi Neticesi Meydana Gelen Residivler
Abstract
This clinical study evaluates the impact of chloramphenicol therapy on typhoid fever cases treated during the summer of 1950 at Ankara University’s Infectious Disease Clinic. Out of 22 hospitalized patients, 11 received chloramphenicol; the remaining served as untreated controls. While untreated cases showed classical progression over 4–5 weeks, those treated with 9 grams of chloramphenicol typically recovered within 3–4 days. However, due to limited drug availability, systematic dosing could not be applied. Of the treated group: 5 achieved complete recovery, 3 experienced relapse (residiv), and 3 showed atypical or prolonged fever. Case details include temperature trajectories, bacteriological findings, and therapeutic outcomes. The study emphasizes that subtherapeutic dosing may suppress fever yet allow pathogens to persist in necrotic foci, risking relapse. It proposes stratified treatment strategies based on infection stage—early, late, or mid-course—and underscores the importance of continuing antibiotics for 5 days after fever resolution. Theoretical discussions include tissue tropism of Salmonella typhi, histopathology of Peyer’s patches, and antibiotic pharmacodynamics.
Keywords
typhoid fever, chloramphenicol therapy, relapse, necrotic focus, antibiotic dosing
References
- 1 - Ehrlich J., Gottlieb D., Burckholder P. R., Anderson I. E., Pridham T. G.: Streptomyces Venezuelae, the source of Chloromycetin. J. Bact. 56:467, 1948.
- 2 - Ley H. L. Jr., Smadel J. E., Crocker T. A.: Administration of Chloromycetin to Normal Human Subjects. Proc. Soc. Exp. Biol. Med. 68:9, 1948.
- 3 - Smith R. M., Joslyn D. A., Gruhzit O. M., McLean I. W. Jr., Penner M. A., Ehrlich J.: Biological Studies on Chloromycetin. J. Bact. 55:425, 1948.
- 4 - Woodward T. E., Smadel J. E., Ley H. L. Jr., Green R., Mankikar D. S.: Effect of Chloromycetin in Typhoid Fever. Ann. Int. Med. 29:131, 1948.
- 5 - Smadel J. E., Woodward T. E.: Relation of Relapses in Typhoid to Duration of Chloramphenicol Therapy. JAMA 141:129, 1949.
- 6 - Long P. H., Chandler C. A., Bliss E. A., Bryer M. S., Schoenbach E. D.: The Use of Antibiotics. JAMA 141:315, 1949.
- 7 - Foster W. D., Candon R. J.: Treatment of Acute Typhoid Fever with Chloromycetin. JAMA 141:131, 1949.