Comparison of Ampicillin and Chloramphenicol in Treatment of Paratyphoid Fever.

ALPHA-AMINOBENZYL penicillin or ampicillin* belongs to the group of synthetic derivatives of 6-aminopenicillanic acid. They are distinguished by a prevalently bactericidal activity, not only on gram positive bacteria, sensitive to penicillin, but also on gram negative bacteria, including salmonellae. Ampicillin is remarkably more active than chloramphenicol or tetracycline in mice infected with Salm. typhimurium (Acred, 1962). Different authors have tried ampicillin on various human salmonella infections in dosages varying from 2 to 4 g. daily. Favourable results have been reported by Stewart, Coles, Nixon and Holt (1961) in one case of peritonitis from Sailm. typhimurium; by Ross, Lovrien, Zaremba, Bruglois and Puig (1962) in ten of 16 patients with enteritis from salmonella; by Kennedy, Wallace and Murdoch (1963) in seven of ten cases of typhoid fever; and by Muddock (1962) in three cases of Salm. typhi infection. A variable percentage of success has also been obtained in salmonella carriers treated with ampicillin (Trafford et al., 1962; Tynes and Utz, 1962; Bullock, 1963). Of particular interest is the work of Sleet, Sangster and Murdoch (1964) on the comparison of ampicillin and chloramphenicol in the treatment of paratyphoid fever. They gave two groups of patients with paratyphoid (a total of 145) either 2 g. of chloramphenicol or 6 g. of ampicillin daily. The duration of the fever was used to evaluate the treatment. The temperature remained high on the average three days after