STUDIES ON CORTISONE AND ANTIBIOTICS FOR PROMPT THERAPEUTIC CONTROL OF TYPHOID FEVER AND SCRUB TYPHUS

Abstract

Eighteen typhoid fever patients were treated between the 9th and 16th days of their disease with chloramphenicol and different schedules of oral cortisone; the responses of 8 scrub typhus patients treated with a uniform regimen of combined cortisone-chloramphenicol therapy were compared with those of a comparable group of 7 patients who received antibiotic alone. The clinical manifestations of the febrile-toxic state in typhoid fever and scrub typhus disappear in about 6 hrs. after initiation of such a combined therapeutic regimen, accompanied by a general sense of well-being and improved appetite. Control of bacteremia was as prompt in typhoid fever treated with the combined regimen as in cases treated with chloramphenicol alone. The incidence of relapse and complications was not influenced by cortisone. The antipyretic effect of a single dose of oral cortisone was temporary, and fever recurred in typhoid fever patients unless admn. of this hormone was continued for a period which corresponds to that required for patients to become afebrile with a regimen consisting solely of chloramphenicol, i.e., about 4 days. In general practice, selected severe cases of typhoid fever may benefit by admn. of cortisone during this period. The importance of adequate control of infection by simultaneous specific therapy is emphasized. Since the response of scrub typhus to antibiotic therapy is generally very prompt, the accelerated defervescence here is primarily of academic interest.