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Changing antibiotic sensitivity in enteric fever
A Gupta1, N K Swarnkar, S P Choudhary
1Medical Unit Ilnd, Sir Padampat Mother and Child Health Institute, Jaipur, India. dr_ashok@sancharnet.in
Insights
Drug resistance in enteric fever is a growing concern. This study found significant ciprofloxacin resistance and emerging ceftriaxone resistance in children, with a potential return of chloramphenicol sensitivity.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Drug resistance in enteric fever poses a significant clinical challenge.
- Monitoring antibiotic resistance patterns is crucial for effective treatment strategies.
Purpose of the Study:
- To prospectively evaluate the clinical presentation and antibiotic response in children with enteric fever.
- To compare current antibiotic resistance trends with historical data from 1990 and 1995.
Main Methods:
- Prospective observational study of hospitalized children with enteric fever from March to May 2000.
- Comparison of clinical outcomes and antibiotic susceptibility with data from 1990 and 1995.
Main Results:
- High rates of resistance to ciprofloxacin (55.5%) were observed.
- Early signs of emerging resistance to ceftriaxone (4.4%) were detected.
- A potential re-emergence of sensitivity to chloramphenicol was noted.
Conclusions:
- Significant shifts in antibiotic resistance patterns for enteric fever are evident.
- Ciprofloxacin resistance is a major issue, necessitating alternative treatment options.
- Chloramphenicol may be regaining efficacy, warranting further investigation.
Abstract:
Emergence of drug resistance in enteric fever is a major concern for the clinician. All children hospitalized with enteric fever during the period 1 March to 31 May 2000 were studied prospectively for their clinical presentation and response to therapy, and an attempt was made to compare these results with the results of hospitalized children with enteric fever during a similar period in the years 1990 and 1995. The results revealed that there was a significant change in the response to antibiotic therapy as evidenced by significant resistance to ciprofloxacin (55.5 per cent) and early evidence of emerging drug resistance to ceftriaxone (4.4 per cent). Although the sample size was small and had its limitations, the results also pointed towards the re-emergence of sensitivity to chloramphenicol.