Typhoid fever is a disease caused by Salmonella Typhi and commonly treated by an antimicrobial agent such as cotrimoxazole. On the other hand, herbal usage has risen as an adjunctive therapy to treat many diseases. Curcuma (Curcuma domestica) is a commonly used herb which consists of curcumin as its major active compound. Curcumin has been known for its antimicrobial effect, but there is no proof regarding the usage of curcumin and cotrimoxazole together. This research was conducted by using typhoid fever model in mice infected by Salmonella Typhimurium. Each animal was treated with curcumin, cotrimoxazole, or both. Ileum, spleen, and liver of each animal were isolated and cultured. We found that curcumin-cotrimoxazole combination therapy lowered the antimicrobial effectivity of cotrimoxazole in both intraintestinal and extraintestinal organs. We conclude that curcumin-cotrimoxazole combination therapy in typhoid fever has to be reconsidered. 1. Introduction Salmonella Typhi is a Gram-negative bacilli which causes typhoid fever in human. This bacterium may survive in phagosome to escape the immune system. Some complications of typhoid fever are perforation of ileum, bacteremia, and endovascular infection [1, 2]. General therapy of typhoid fever is antimicrobial agents, such as chloramphenicol, ampicillin, and cotrimoxazole (trimethoprim-sulfamethoxazole). Cotrimoxazole is commonly used for typhoid fever therapy in adults and children, including carrier, as an alternative to ampicillin and quinolone. Cotrimoxazole inhibits folic acid synthesis which is needed by bacteria to synthesize nucleic acid [3]. Curcumin is a major active compound of curcuma (Curcuma domestica), which is widely used as traditional therapy for fever and gastrointestinal problems in Asia. Curcumin has both anti-inflammation and antibacterial effects. It may bind to vitamin D receptor and stimulates expression of an antibacterial protein called cathelicidin [4–6]. Combination between antimicrobial agent and herbal medicine has become a recent trending topic, but there is not enough research to prove that this combination is beneficial to treat typhoid fever. Much more research is needed to find any possible effect of this combination. This study was preceded by an exploration study to ensure antimicrobial effect of both curcumin and cotrimoxazole toward S. Typhimurium. 2. Materials and Methods 2.1. Animal Preparation Male BALB/c mice underwent acclimatization in laboratory for seven days with free access to meal and water. Animals were randomized into groups and were treated with
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