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Multidrug resistant typhoid fever: therapeutic considerations.
S Mishra1, A K Patwari, V K Anand
1Department of Pediatrics, Lady Hardinge Medical College, New Delhi.
Indian Pediatrics
|April 1, 1992
Summary
This study investigated multidrug-resistant typhoid fever (MRTF) caused by E1 phage type. Ceftriaxone and cefotaxime showed promising results against resistant strains, offering alternatives for treatment.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- An outbreak of multidrug-resistant typhoid fever (MRTF) was identified.
- The causative agent was identified as E1 phage type.
- Organisms exhibited resistance to common typhoid treatments like chloramphenicol, co-trimoxazole, and ampicillin.
Purpose of the Study:
- To analyze the drug resistance patterns of MRTF during the outbreak.
- To evaluate the efficacy of various antimicrobial agents in treating MRTF.
- To identify effective treatment options for multidrug-resistant typhoid fever.
Main Methods:
- Blood cultures from 46 patients with MRTF were analyzed.
- Antimicrobial susceptibility testing was performed for commonly used drugs.
- Clinical outcomes were assessed based on treatment regimens.
Main Results:
- High resistance rates were observed for chloramphenicol (78%), co-trimoxazole (76%), and ampicillin (68%).
- Treatment failures with chloramphenicol (45.5%) correlated with in vitro resistance.
- Ceftriaxone and cefotaxime demonstrated high clinical success rates in sensitive strains.
Conclusions:
- The E1 phage type MRTF outbreak highlights significant antimicrobial resistance challenges.
- Ceftriaxone and cefotaxime are effective alternatives for treating susceptible MRTF infections.
- Treatment strategies must adapt to evolving resistance patterns in typhoid fever.