Treatment of typhoid carriers with amoxicillin. Correlates of successful therapy

Abstract

Fifteen chronic enteric carriers of Salmonella typhi were treated with amoxicillin trihydrate, 2 g by mouth, 3 times/day. Of 10 patients who were able to take the full amoxicillin regimen, 9 were cured; among 5 patients treated with a lower daily amoxicillin dosage because of gastrointestinal (GI) side effects, only 2 were cured (P < .05). The mean serum amoxicillin concentration at termination of therapy was higher (P < .0) in 5 patients who were cured (10.4 .+-. 1.6 .mu.g/ml) than in the 4 who failed (3.0 .+-. 0.7 .mu.g/ml), although the latter values were all above the minimal inhibitory concentrations for infecting organisms. Amoxicillin treatment of chronic typhoid carriers could possibly be enhanced by treating with doses sufficient to provide suprainhibitory serum concentrations of the antibiotic. GI intolerance to amoxicillin could limit this therapeutic approach.