Typhoid fevers: treatment with lomefloxacin

Typhoid group of fevers pose a major threat and are a cause of high morbidity and mortality in the tropical countries. Over the last decade there has been a steady increase in the development of multiresistant strains of Salmonellae all over the world. Multiresistance ranges between 5% to 86%. In a recent study in Pakistan multidrug resistance in Salmonellae has increased to over 39%. Hence alternative therapy is needed. Fluroquinolones are an effective alternative requiring a shorter course of treatment than conventional antimicrobial agents. Lomefloxacin because of its longer half life and convenient BD dose was used in a multicentre study to treat cases of typhoid group of fevers including cases due to multiresistant isolates. In order to overcome the challenge presented by the multiresistant salmoneallae, a dual purpose multicentre study was conducted in two stages. The first stage included a vitro study and the second in vivo study. Two hundred local salmonellae isolates were collected and their sensitivity and minimum inhibitory concentrations were determined by standard methods. Two hundred and fourteen patients clinically suspected of suffering from typhoid groups of fevers were given Lomefloxacin 200 mg. BD for 14 days. Forty percent of Salmonellae isolates were found to be multiresistant while only 2% were found to be resistant to Fluroqunilones. The mean MIC 90 was found to be 0.06 mg/L Lomefloxacin was found to be effective in over 97% cases for treating typhoid group fevers including the ones due to multiresistant isolates. The side effects were found to be minimal and transient.