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Drug-resistant salmonellosis.

Arup Kumar Kundu1

  • 1Department of Medicine, NRS Medical College, Kolkata.

Journal of the Indian Medical Association
|October 18, 2005
PubMed
Summary

Chromosomally-mediated quinolone resistance is a growing concern in typhoid fever, leading to ciprofloxacin treatment failures. Third-generation cephalosporins offer a promising alternative, with some studies noting a return of sensitivity to older drugs like chloramphenicol.

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Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Plasmid-mediated resistance to first-line drugs has been established.
  • Emergence of chromosomally-mediated quinolone resistance in typhoid fever is a significant clinical challenge.
  • Increasing reports of quinolone insensitivity and treatment failures with ciprofloxacin necessitate alternative therapeutic strategies.

Purpose of the Study:

  • To highlight the growing concern of quinolone resistance in typhoid fever.
  • To discuss the efficacy of third-generation cephalosporins as an alternative treatment.
  • To report on the observed return of sensitivity to older antibiotics.

Main Methods:

  • Literature review on antimicrobial resistance patterns in typhoid fever.
  • Analysis of clinical data on treatment outcomes with various antibiotics.
  • Surveillance of antibiotic sensitivity trends.

Main Results:

  • Chromosomally-mediated quinolone resistance is an increasing problem in typhoid fever.
  • Ciprofloxacin treatment failures are frequently reported.
  • Third-generation cephalosporins are effective alternatives.
  • Some studies indicate a resurgence of sensitivity to chloramphenicol and furazolidone.

Conclusions:

  • The rise in quinolone resistance requires strategic treatment adjustments.
  • Higher doses and longer treatment durations may help overcome fluoroquinolone insensitivity.
  • Third-generation cephalosporins represent a viable therapeutic option.
  • The re-emergence of sensitivity to chloramphenicol and furazolidone is a positive development for typhoid fever management.

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