Background Azithromycin and trimethoprim-sulfamethoxazole (SXT) are widely used to treat undifferentiated febrile illness (UFI). We hypothesized that azithromycin is superior to SXT for UFI treatment, but the drugs are noninferior to each other for culture-confirmed enteric fever treatment. Methods We conducted a double-blind, randomized, placebo-controlled trial of azithromycin (20 mg/kg/day) or SXT (trimethoprim 10 mg/kg/day plus sulfamethoxazole 50 mg/kg/day) orally for 7 days for UFI treatment in Nepal. We enrolled patients >2 years and
We compared azithromycin with trimethoprim-sulfamethoxazole for 7 days in the treatment of undifferentiated febrile illness in Nepal. Despite similar fever clearance time and treatment failure in the 2 arms, significantly fewer complications and relapses were noted in the azithromycin arm.