Chloramphenicol is the most effective drug treatment for S. typhi, and symptoms begin to improve slightly after only 24-48 hours of receiving the medication. Another drug, ceftriaxone, has been used recently, and is also extremely effective, lowering fever fairly quickly.
Carriers of S. typhi must be treated even when asymptomatic, as they are responsible for the majority of new cases of typhoid fever. Eliminating the carrier state is actually a fairly difficult task, and requires treatment with one or even two different medications for four to six weeks. In the case of a carrier with gall stones, surgery may need to be performed to remove the gall bladder, because the S. typhi bacteria are often housed in the gall bladder, where they may survive despite antibiotic treatment.