A placebo (sugar pill) will be used instead of cefixime in the single drug arm so that neither the patient nor the study team knows which patient is receiving which treatment. Investigators will assess whether treatment outcomes are better with the combination after one week of treatment and at one and three-month follow-ups.

Both antimicrobials are widely used and have excellent safety profiles. If the combination treatment is better than the single antibiotic treatment, this will be an important result for patients across South Asia and other typhoid endemic areas. This study will additionally investigate the financial implications for families and the health system.

Treatment with combinations of antimicrobials may be more effective for treating typhoid fever and mitigating the problems of resistance.

The total recruitment will be 1500 patients across sites in Bangladesh, India, Nepal and Pakistan.