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ENTERIC FEVER - CULTURE AND SENSITIVITY PATTERN AND TREATMENT OUTCOME
C H Gidvani1, Vipan Chandar2, D Raghunath3
1Commandant, Military Hospital Agra Cantt.
Abstract:
One hundred cases of enteric fever in the age group of 6 months to 12 years were analysed with respect to culture sensitivity pattern and treatment outcome. Patients were divided into 5 treatment groups - chloramphenicol, amoxycillin, trimethoprim-sulfamethoxazole + furazolidine, gentamicin + cephalexin and ciprofloxacin. Out of 91 culture positive cases, 100% were sensitive to ciprofloxacin followed by gentamicin (84.9%), cephalexin (83.6%), furazolidine (36.6%), trimethoprim-sulfamethoxazole (34.1%), chloramphenicol (34.0%) and amoxycillin (23.8%). In 60 cases resistant to chloramphenicol, resistance to other drugs varied from 20 to 88.3%. The treatment response was 100% to ciprofloxacin, 72.7% to chloramphenicol, 50% to gentamicin + cephalexin, 38.5% to trimethoprim-sulfamethoxazole + furazolidine and 12.5% to amoxycillin. Out of 48 cases who did not respond to initial regimen, 33 were treated successfully with ciprofloxacin and remaining with other drug regimens. Time taken for defervescence was shortest with gentamicin + cephalexin (4.6±2.0 days) followed by ciprofloxacin (6.1±2.5 days) and chloramphenicol (6.4±3.5 days). There were 3 deaths in this study.
Insights
Ciprofloxacin demonstrated 100% sensitivity and treatment response in pediatric enteric fever cases. This antibiotic offers a highly effective treatment option, outperforming traditional drugs like chloramphenicol.
Area of Science:
- Pediatric Infectious Diseases
- Antimicrobial Resistance
- Clinical Pharmacology
Background:
- Enteric fever remains a significant public health concern in children.
- Increasing antimicrobial resistance necessitates evaluating current treatment regimens.
- Understanding drug sensitivity patterns is crucial for effective management.
Purpose of the Study:
- To analyze the culture sensitivity patterns of enteric fever pathogens.
- To evaluate the treatment outcomes of various antibiotic regimens in children.
- To identify optimal therapeutic strategies for pediatric enteric fever.
Main Methods:
- A prospective study of 100 children (6 months to 12 years) with enteric fever.
- Patients were assigned to one of five treatment groups: chloramphenicol, amoxycillin, trimethoprim-sulfamethoxazole + furazolidine, gentamicin + cephalexin, or ciprofloxacin.
- Culture sensitivity testing and treatment response were assessed for each group.
Main Results:
- Ciprofloxacin showed 100% sensitivity among culture-positive cases.
- Treatment response rates were highest for ciprofloxacin (100%) and chloramphenicol (72.7%).
- Gentamicin + cephalexin achieved the shortest defervescence time (4.6 days).
Conclusions:
- Ciprofloxacin is a highly effective and sensitive treatment for pediatric enteric fever.
- Alternative regimens may be necessary for patients resistant to first-line therapies.
- Further research into optimal drug combinations and resistance mechanisms is warranted.
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