Talk to Pediatrician on Typhoid Fever

Patient: 3-year-old girl, weight 15 kg. Fever started Thursday night, initially up to 102°F, with throat pain, poor appetite and watery vomiting. She was evaluated by a pediatrician and started on Azomax (azithromycin); Ceclor was subsequently stopped. Blood culture (sample taken 24-Aug at 11:51 AM): Final culture grew Salmonella Typhi after 36 hours. Sensitivity: Azithromycin – Sensitive, Meropenem – Sensitive. Resistant to Ampicillin, Ceftriaxone, Ciprofloxacin, Cotrimoxazole and Chloramphenicol. � 1000193140.jpg CBC: WBC 6.1, Hb 11.2, platelets 134k, MCV 73. ALT 53 U/L. Urine examination essentially normal. She is currently taking Azomax 4 mL as prescribed. Fever improved significantly and she remained fever-free for almost a full day, but fever returned during the night and again this morning, responding to fever medicine. Currently she is alert, well-oriented, drinking water willingly and has no breathing difficulty. She is somewhat irritable/stubborn but otherwise behaving normally. Please advise whether the current Azomax dose/course should be continued based on the culture sensitivity, and whether any further evaluation or treatment adjustment is required given the recurrent fever.