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Chloramphenicol resistant enteric fever
B Chakravorty1, N Jain, B Gupta
1Department of Medicine, Safdarjang Hospital, New Delhi.
Journal of the Indian Medical Association
|January 1, 1993
Summary
Chloramphenicol remains a primary choice for enteric fever, effectively treating most cases despite emerging resistance. Some patients resistant in lab tests still respond to this crucial antibiotic.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Reports indicate increasing chloramphenicol resistance in enteric fever.
- Alternative antimicrobial agents are being explored due to resistance concerns.
Purpose of the Study:
- To evaluate the clinical profile of patients with chloramphenicol-resistant enteric fever.
- To assess the continued efficacy of chloramphenicol and alternative treatments for enteric fever.
Main Methods:
- Clinical data from 15 patients with chloramphenicol-resistant enteric fever were analyzed.
- Treatment outcomes were compared between chloramphenicol-sensitive and resistant cases.
- Efficacy of ciprofloxacin, gentamicin, and ofloxacin was assessed in resistant cases.
Main Results:
- Despite in vitro resistance, 20% of patients responded to chloramphenicol.
- Chloramphenicol achieved a cure rate of 68.4% in the overall study population (38 patients).
- Ciprofloxacin, gentamicin, and ofloxacin showed satisfactory response rates of 46.7%, 20%, and 13.3% respectively in resistant cases.
- Drug-resistant cases exhibited a higher incidence of complications compared to sensitive cases.
Conclusions:
- Chloramphenicol remains a valuable first-line treatment for enteric fever, with a significant overall cure rate.
- Alternative antibiotics like ciprofloxacin, gentamicin, and ofloxacin are effective options for resistant strains.
- Increased complications are associated with drug-resistant enteric fever, highlighting the need for effective treatment strategies.