The following is generally the drug of first choice in typhoid

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Pharmacology

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2023

Explanation

Ciprofloxacin is a fluoroquinolone antibiotic that was widely regarded as the drug of choice for treating typhoid fever caused by susceptible Salmonella typhi strains.
It acts by inhibiting bacterial DNA gyrase, an enzyme essential for DNA replication, leading to bacterial death.
Compared to older drugs like chloramphenicol and amoxicillin, fluoroquinolones offered a shorter treatment course (5-7 days) and were more rapidly effective.
Among the given options, Ciprofloxacin is the most appropriate choice, although its first-line status is now challenged by resistance.

Option A: Amoxicillin was historically a first-line treatment for typhoid, but its use is now limited due to the high prevalence of multidrug-resistant (MDR) strains of S. typhi.
Option B: Tetracycline is not indicated as a primary treatment for typhoid fever.
Option C: Erythromycin, a macrolide, is not effective against Salmonella typhi.

Clinical Relevance

Nursing practice connection: Knowing Pharmacotherapy for Typhoid Fever helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) typhoid is a major public health concern, especially in South Asia. Nurses must be aware that empirical treatment guidelines have shifted.
Nurses play a critical role in infection control through enteric precautions, promoting hand hygiene, and ensuring safe food and water practices to prevent fecal-oral transmission.
Patient education is vital. Nurses must stress the importance of completing the full course of antibiotics to prevent relapse and the development of a chronic carrier state (e.g., in the gallbladder).

How to Approach the Question

First, identify the core of the question: it asks for the 'drug of first choice' for 'typhoid'. This is a factual recall question from pharmacology.
Recall the common antibiotics used to treat typhoid fever. Historically, this included chloramphenicol, amoxicillin, and co-trimoxazole.
Remember that fluoroquinolones, like Ciprofloxacin, became the mainstay of treatment due to their high efficacy and shorter duration.
Evaluate the given options: Amoxicillin (historical, resistance issues), Tetracycline (not for typhoid), Erythromycin (ineffective), and Ciprofloxacin (a known effective agent).
Select Ciprofloxacin as the best answer among the choices provided, while mentally noting that current practice is heavily influenced by local resistance patterns, often favoring other drugs like Ceftriaxone or Azithromycin empirically.

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