The combination of pivmecillinam and pivampicillin compared to co-trimoxazole in the treatment of enteric fever.

Typhoid fever is an infectious disease with multisystem involvement and is commonly seen in the tropics. Twelve patients with acute typhoid fever were successfully treated with a fixed dose combination of pivmecillinam and pivampicillin. The treatment results were compared to those obtained from the treatment of ten other patients with co-trimoxazole, which is the routine treatment of our Department. The two forms of treatment appeared to be equally effective, suggesting that the combination mecillinam/ampicillin may represent a valuable alternative to the antityphoidal drugs currently available. Eleven patients were infected with strains resistant in vitro to either ampicillin, chloramphenicol, or both. All clinical isolates were sensitive to co-trimoxazole and to the combination of mecillinam and ampicillin. MIC values for the combination ranged from 0.16 to 2.5 mg/l. No side-effects were recorded.