title: [Two cases of typhoid fever with reduced susceptibility to fluoroquinolones].
abstract: Two separate febrile Indian patients who reside in Japan and had recently returned from their country were diagnosed as suffering from typhoid fever. Fluoroquinolone therapy was clinically ineffective and the addition of a third-generation cephalosporin was required in each case. Each strain of Salmonella Typhi was resistant to nalidixic acid in vitro and also showed higher minimal inhibitory concentration to other quinolones than usual susceptible strains. Similar cases of typhoid fever responding poorly to quinolone treatment have been observed in the Indian subcontinent, south-east Asia and central Asia since the early 1990s, and potential spread by travelers into Japan is of serious concern. Although quinolones still remain the drugs of choice for treatment of typhoid fever, physicians should be aware of the possibility and implications of clinical treatment failure.
authors.affiliation: Department of Infectious Diseases, Tokyo Metropolitan Komagome Hospital.
authors.forename: T
authors.initials: T
authors.lastname: Adachi
authors.forename: G
authors.initials: G
authors.lastname: Masuda
authors.forename: A
authors.initials: A
authors.lastname: Imamura
authors.forename: A
authors.initials: A
authors.lastname: Ajisawa
authors.forename: M
authors.initials: M
authors.lastname: Negishi
authors.forename: N
authors.initials: N
authors.lastname: Takayama
authors.forename: K
authors.initials: K
authors.lastname: Takinaga
authors.forename: S
authors.initials: S
authors.lastname: Takano
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000493:pharmacokinetics* / Q000494:pharmacology* / Q000627:therapeutic use; D002648:Child; D004352:Drug Resistance, Microbial; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D007194:India / Q000208:ethnology; D007564:Japan; D008297:Male; D012485:Salmonella typhi / Q000187:drug effects; D014435:Typhoid Fever / Q000188:drug therapy* / Q000382:microbiology*
chemical_list: D000890:Anti-Infective Agents; D024841:Fluoroquinolones