**Question:** Which of the following drugs is not given in enteric fever?

A. Ciprofloxacin
B. Amoxicillin
C. Oral fluids and electrolyte replacement
D. Paracetamol

**Core Concept:** Enteric fever is a bacterial infection primarily caused by Salmonella typhi and Salmonella paratyphi, primarily affecting the gastrointestinal tract and liver. The standard treatment for enteric fever typically involves a combination of drugs to combat the infection and manage its complications.

**Why the Correct Answer is Right:** Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic that is effective against Gram-negative bacteria, including Salmonella species. However, it is not used as a monotherapy for enteric fever because of its narrow spectrum, which may not adequately cover the wide range of pathogens involved in the disease.

**Why Each Wrong Option is Incorrect:**

A. Amoxicillin is a penicillin antibiotic with a narrower spectrum than ciprofloxacin, making it unsuitable for treating enteric fever.
B. Oral fluids and electrolyte replacement are essential supportive measures in the management of enteric fever, not a drug.
D. Paracetamol is an analgesic and antipyretic agent, not an antibiotic, and is not used as a treatment for enteric fever.

**Clinical Pearl:** The standard treatment for severe uncomplicated enteric fever involves a combination of drugs that target different aspects of the disease. A commonly used regimen consists of a fluoroquinolone (e.g., ciprofloxacin) in combination with a third-generation cephalosporin (e.g., ceftriaxone) and a benzathine penicillin G for coverage against Streptococcus pneumoniae. Intravenous administration, close monitoring, and appropriate supportive care are crucial for the successful treatment of enteric fever.