American Board of Internal Medicine (ABIM) Certification Practice Exam

Which antibiotics are commonly used to treat typhoid fever?

1. Ceftriaxone, fluoroquinolones, and azithromycin

2. Piperacillin and tazobactam

3. Vancomycin and clindamycin

4. Metronidazole and ampicillin

The correct answer is: Ceftriaxone, fluoroquinolones, and azithromycin

Typhoid fever, caused by Salmonella enterica serotype Typhi, is primarily treated with antibiotics. The correct choice includes ceftriaxone, fluoroquinolones, and azithromycin, which are the mainstay antibiotics for this infection. Ceftriaxone is a third-generation cephalosporin that provides effective coverage against gram-negative bacteria, including Salmonella Typhi. It is commonly used in severe cases, particularly when intravenous treatment is required. Fluoroquinolones, such as ciprofloxacin and ofloxacin, are also effective against Salmonella species and are often used as oral alternatives. Due to their efficacy and ease of administration, they have been a popular choice, although resistance is becoming more common. Azithromycin is a macrolide antibiotic that has shown effectiveness against resistant strains of Salmonella Typhi. It is particularly useful for patients who might not tolerate or have resistance to other classes of antibiotics. The other options, while being effective against various infections, do not have the appropriate spectrum of activity or are not the typical first-line treatments for typhoid fever. Piperacillin and tazobactam are generally used for mixed infections, while vancomycin and clindamycin