Comparison of Single vs Combination Drug Therapy in Extensively Drug Resistant Salmonella typhi: An Observational Study from Pakistan

Ishaque, Sadia; Syed, Beenish; Dodani, Sunil Kumar; Anwar, Saba

doi:10.2147/idr.s372136

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…The study reinforces the importance of ongoing surveillance and monitoring of antibiotic efficacy. Meropenem demonstrated 100% sensitivity, indicating its effectiveness against Salmonella typhi, aligning with its classification as a potent carbapenem against Gramnegative bacteria (Ishaque et al, 2022). However, caution is necessary in its use due to the risk of contributing to antibiotic resistance.…”

Section: Discussionmentioning

confidence: 80%

Pattern of Antibiotic Sensitivity in Typhoid Fever Patients With Positive Blood Culture: An Observational Study

KHAN,

BASIT

et al. 2024

Biol Clin Sci Res J

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Salmonella typhi is a type of bacteria that can cause typhoid fever, a severe infection that primarily affects people in developing countries. It is a significant public health concern. An antibiogram test was conducted by the Department of Medicine at MTI, LRH Peshawar, to test antibiotic susceptibility in samples that tested positive for typhoid culture from January 2023 to July 2023. The Kirby-Bauer disk diffusion method was used to evaluate the antibiotic susceptibility of Salmonella isolates on Mueller-Hinton agar. IBM SPSS version 22 was used to analyze all of the data. In total, 90 people participated in the research, with 40 percent being female and 50 percent male. Of the Salmonella isolates, 08 (28.20%) were sensitive to typhoid, 18 (68.80%) were MDR, and 01 (04%) were XDR. Of the 27 isolates, 6 (21.40%) showed Ampicillin sensitivity, while 21 (81.40%) showed resistance to the antibiotic. 90.20% of the isolates were resistant to chloramphenicol, while 15.60% were susceptible. 60.20% of the isolates were resistant to ceftriaxone, while 41.40% showed sensitivity to the drug. Nine isolates (30.40%) showed sensitivity to ciprofloxacin, while eighteen isolates (68.40%) showed resistance. 26 27 isolates (91.40%) showed sensitivity to azithromycin, while 01 (02.40%) showed resistance. Meropenem was the most effective antibiotic, with 100% of the isolates exhibiting Meropenem sensitivity. Based on the findings, azithromycin and meropenem are the most effective antibiotics against isolates of Salmonella spp. MDR and XDR strains of enteric fever are on the rise and exhibit a high degree of resistance to commonly prescribed medications. Antibiotic use without a prescription should be minimized, and prescribing practices should be modified.

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Section: Discussionmentioning

confidence: 80%

Pattern of Antibiotic Sensitivity in Typhoid Fever Patients With Positive Blood Culture: An Observational Study

KHAN,

BASIT

et al. 2024

Biol Clin Sci Res J

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“…Therefore, the decision to escalate to meropenem was made. Recent studies have been targeting the effectiveness of using monotherapy versus combination therapy (azithromycin and carbapenems) in the treatment of XDR typhoid fever, some showing that the use of single antibiotic therapy has achieved defervescence earlier than combination therapy [ 10 ]. However, more evidence-based studies are needed to assess the effectiveness of monotherapy in the treatment of XDR typhoid fever.…”

Section: Discussionmentioning

confidence: 99%

Fatal Complications of Extensive Drug-Resistant Typhoid Fever: A Case Report

AlAgha¹

2023

Cureus

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Typhoid fever is a systemic illness that often presents with fever, abdominal pain, and diarrhea. There are multiple complications associated with typhoid fever which includes intestinal perforation, gastrointestinal hemorrhage, hepatitis, and anemia. In recent years, a new extensively drug resistant (XDR) strain of Salmonella typhi (S. typhi) emerged, associated with higher incidence of complications, responding to azithromycin and carbapenems only. In this article, we report a case of a 28-year-old Pakistani male who initially presented with fever and bloody diarrhea, complicated by massive lower gastrointestinal bleed, leading to his mortality. This case, being the first reported case in Bahrain, illustrates the importance of considering hepatic manifestations and lower gastrointestinal bleeding as fatal complications of typhoid fever, especially in the setting of recent travel to Southeast Asia.

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Effectiveness of Oral Azithromycin in Treating Enteric Fever: A Hospital-Based Study on Pediatric Patients

Khan,

Babar

et al. 2024

Cureus

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IntroductionEnteric fever is prevalent in underdeveloped and developing countries. It is caused by Salmonella Typhi, which has developed resistance over the years to commonly used antimicrobials. Meropenem is an effective treatment for all complicated and uncomplicated extensively drug-resistant (XDR) bacteria, but it is administered intravenously, three times daily, by infusion, and it is quite expensive for the patient. Oral azithromycin is shown by some authors to be effective in extensively drug-resistant enteric fever. Material and methodsThis retrospective cross-sectional study was conducted in the outpatient department of Lady Reading Hospital Medical Teaching Institution, Peshawar. The duration of the study was one year. Data was collected after approval from the hospital's Ethical and Research Committee. All pediatric patients meeting the inclusion criteria for extensively drug-resistant enteric fever were included. Data on patient demographics, blood culture and laboratory results, treatment given, and effectiveness were documented in a specialized proforma. Statistical Package for Social Sciences (SPSS) version 23 (IBM Corp., Armonk, NY, US) was used for data analysis. ResultsOut of the total 106 patients, 72 (67.9%) were male and 34 (32.1%) were female. The mean age was 7.51 ± 2.75 years, with a range of 1 to 15 years. Among them, 66 (62.3%) had anemia (hemoglobin less than 11 grams per deciliter for under 5 years and 11.5 for 5-15 years old children), with a mean hemoglobin level of 10.6 ± 1.53 grams per deciliter (g/dl), ranging from 7.2 to 13.8 g/dl. Thrombocytopenia was found in 14 (13%) patients.The mean platelet count was 317 x 10 3 ± 164 cells per microliter, with a range of 61 x 10 3 to 834 x 10 3 cells per liter. The mean total leukocyte count was 9.71x 10 3 ± 4.321 cells per microliter, with a range of 2.01 x 10 3 to 30.40 x10 3 cells per microliter. However, leucopenia was seen in only 5 (4.7%) patients. In 98.1% of cases, azithromycin was found to be effective in treating enteric fever caused by extensively drug-resistant Salmonella. ConclusionAzithromycin is effective in treating extensively drug-resistant enteric fever. It can be confidently used in patients with no or mild complications with extensively drug-resistant enteric fever. Good compliance and complete dosage should be followed to avoid resistance to this drug. Blood cultures should always be sent when prescribing antibiotics, especially when suspecting enteric fever.

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Comparison of Single vs Combination Drug Therapy in Extensively Drug Resistant Salmonella typhi: An Observational Study from Pakistan

Cited by 3 publications

References 15 publications

Pattern of Antibiotic Sensitivity in Typhoid Fever Patients With Positive Blood Culture: An Observational Study

Pattern of Antibiotic Sensitivity in Typhoid Fever Patients With Positive Blood Culture: An Observational Study

Fatal Complications of Extensive Drug-Resistant Typhoid Fever: A Case Report

Effectiveness of Oral Azithromycin in Treating Enteric Fever: A Hospital-Based Study on Pediatric Patients

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