Can We Restart the First-Line Antibiotic as Empirical Choice When Enteric Fever is Suspected?

Area of Science:

• Medical Microbiology
• Infectious Diseases
• Antimicrobial Resistance

Background:

• Enteric fever poses a significant health challenge in Bangladesh.
• Physicians hesitate to use first-line antibiotics due to concerns about antimicrobial resistance.
• Understanding local resistance patterns is crucial for effective treatment.

Purpose of the Study:

• To determine the year-wise sensitivity patterns of first-line antibiotics against Salmonella typhi and Salmonella paratyphi in Bangladesh.
• To evaluate the trends in antibiotic sensitivity over a three-year period (2017-2019).
• To inform empirical treatment guidelines for enteric fever.

Main Methods:

• Retrospective analysis of blood culture and sensitivity data from Bangladesh Medical College Hospital.
• Evaluation of isolates of Salmonella typhi and Salmonella paratyphi from January 2017 to December 2019.
• Assessment of sensitivity patterns for Amoxycillin, Cotrimoxazole, and Chloramphenicol.

Main Results:

• Salmonella typhi and Salmonella paratyphi were the predominant isolates, accounting for 73.74% and 15.32% respectively.
• Sensitivity to Amoxycillin, Cotrimoxazole, and Chloramphenicol showed an increasing trend for Salmonella typhi from 2017 to 2019.
• Similar increasing sensitivity patterns were observed for Salmonella paratyphi, with high sensitivity also noted for third-generation cephalosporins.

Conclusions:

• First-line antibiotics demonstrate increasing sensitivity against Salmonella typhi and Salmonella paratyphi in Bangladesh.
• The study recommends the use of first-line antibiotics as empirical treatment for enteric fever.
• Continued monitoring of antibiotic sensitivity patterns is essential for effective disease management.