Uncomplicated: Azithromycin, Cotrimoxazole, Cefixime (alternative — fever settles more slowly)
Complicated / not taking orally: Ceftriaxone
Advice and when to refer
Advice: Blood culture before antibiotics; no Widal; no fluoroquinolones; fever takes 4–5 days to settle — do not switch antibiotics for that alone (NCDC-ICMR 2025)
Investigations
First visit
Blood culture — The test of choice: take before the first antibiotic dose; highest yield in the first week.
CBC — Normal or low white count; low platelets suggest dengue or malaria instead.
Malaria RDT and dengue NS1/IgM — Exclude the common mimics in the same visit.
Only if indicated
LFT and creatinine — If unwell, jaundiced or vomiting.
Stool or bone marrow culture — Blood culture negative after antibiotics and fever persists — at a higher centre.
Widal test — Not recommended: false positives are common in India and it should not decide treatment.
Follow-up and monitoring
Clinical review at day 5 — Fever takes 4–5 days to settle; do not repeat cultures or switch antibiotics for that alone.
Locked
The adult dose for each drug
The child dose, where the card gives one
Indian brand names for each drug, with a link to buy
ICU Decoded — original critical-care and internal-medicine pathways by
Dr Javed Akhtar, each cited to a current guideline. For education and quick
reference; verify every dose against local protocols before prescribing.