Evaluation of antibiotic sensitivity pattern in cases of enteric fever in north west Rajasthan.
A total of 50 cases of blood culture proved enteric fever were studied for clinical response to the treatment and compared with in vivo antibiotic sensitivity pattern. Out of 50 Salmonella strains isolated, 37 were S typhi and 13 S paratyphi A. All S typhi isolates were sensitive in vitro to gentamicin and ceftriaxone while sensitivity to ciprofloxacin was 73%, ampicillin 29.7%, chloromphenicol 27%, tetracycline 27% and co-trimoxazole 13.5%. Multidrug resistance (Ampicillin, Chloramphenicol, Cotrimoxazale and Tetracycline) was observed in 62% isolates. All Sparatyphi A isolates were sensitive to all the antibiotics. Clinical response to the antibiotic therapy was as follows: Group I--Ampicillin + Gentamicin: 15 cases, clinical response (CR), 9.1% (S typhi) and 75% (S paratyphi A), mean day of defervescence 5.33 days. Group II--Ciprofloxacin: 29 cases, clinical response 47.6% (S typhi) and 75% (S paratyphi A), mean day of defervescence--5.22 days. Group--III Ceftriaxone: 30 cases, clinical response 100% in all, mean day of defervescence--4.93 days. Thus we observed highly significant discrepancy in antibiotic sensitivity pattern of the isolates and clinical response. Most importantly we observed significantly delayed clinical response to the ceftriaxone. This may be indicative of evolving resistance to ceftriaxone.
Saharan
Gopi
G
Department of Medicine and Microbiology, SP Medical College and AG of Hospitals, Bikaner 334003.
Gupta
Anjli
A
Gupta
B K
BK
Sharma
B P
BP
Kochar
D K
DK
Purohit
V P
VP
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002443:Ceftriaxone / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000627:therapeutic use; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007194:India; D008297:Male; D008826:Microbial Sensitivity Tests / Q000706:statistics & numerical data; D008875:Middle Aged; D014435:Typhoid Fever / Q000097:blood / Q000188:drug therapy*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002443:Ceftriaxone