title: A case of clinical and microbiological failure of azithromycin therapy in Salmonella enterica serotype Typhi despite low azithromycin MIC.
abstract: Typhoid fever remains a serious problem in many developing countries. Due to resistance to multiple first line drugs, azithromycin has evolved as an important drug in the treatment of typhoid. While therapy with azithromycin is highly effective, no clinically validated mean inhibitory concentration (MIC) break points or disc diffusion cutoff guidelines are available so far. We describe an Indian adult with clinical and microbiological failure to azithromycin despite low azithromycin MIC.
authors.affiliation: Department of Infectious Diseases, Christian Medical College, Vellore, India. Electronic address: abimanesh@gmail.com.
authors.forename: Abi
authors.initials: A
authors.lastname: Manesh
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, India. Electronic address: vbalaji@cmcvellore.ac.in.
authors.forename: Veeraraghavan
authors.initials: V
authors.lastname: Balaji
authors.affiliation: Department of Clinical Microbiology, Christian Medical College, Vellore, India. Electronic address: speed.naveen1@gmail.com.
authors.forename: Devanga Ragupathi Naveen
authors.initials: DR
authors.lastname: Kumar
authors.affiliation: Department of Infectious Diseases, Christian Medical College, Vellore, India. Electronic address: prisci@cmcvellore.ac.in.
authors.forename: Priscilla
authors.initials: P
authors.lastname: Rupali
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D012485:Salmonella typhi / Q000187:drug effects* / Q000302:isolation & purification / Q000502:physiology; D065288:Serogroup; D017211:Treatment Failure; D014435:Typhoid Fever / Q000188:drug therapy* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin
keywords: Azithromycin; MIC within susceptible range; Salmonella enterica serotype Typhi; clinical failure