The Treatment of Typhoid and Paratyphoid Carriers

Abstract

In the previous report in this magazine, the auther gave his own view on the condition causing and developing biliary typhoid carrier state and on its treatment, based upon his experience with 16 cariier cases.
In this report, adding 16 more cases to the previous ones-including two cases of continuous observation from the previous study time-the author reviewed the results of antibiotic treatment including Aminobenzyl-Penicillin treatment, long-term-small-everyday-dosis Tetracycline administration, and some other antibiotic treatment and the effect of post-operative Kanamycin instillation method through T shaped tube.
The followings are principles of the treatment believed to be recommendable at the present stage of this field:
1) Relatively large amount (2g or more daily dose) of Aminobenzyl-Penicillin should be administrated from the beginning of the treatment regardless the outcome of cholecystography. The other antibiotics were proved to be ineffective.
2) In unsuccessful and stone-bearing cases, cholecystectomy should be performed. Post-operatively, Kanamycin solution of high concentration should be instillated into the bile tracts 2 times a day through a T shaped tube.
3) If encountered yet unsuccessful cases, there can be some possibilities that the tube itself began acting as a foreign body like stone and becoming rather harmful in the course of protracted manipulations. In this case, the tube should be removed. Instead, observations with or without antibiotics administration must follow for some time. The author experienced two cases showing spontaneous recovery after having undergone these procedures.
The author believes that typhoid or paratyphoid carriers are no longer hopeless or intractable.