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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
PubMed
Summary
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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.

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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.