A study of culture positive multidrug resistant enteric fever--changing pattern and emerging resistance to ciprofloxacin

Abstract

The present prospective study was carried out to observe the changing trends in the clinical pattern and multidrug resistance in typhoid fever. Fever was the main presenting feature. Other associated features were headache, vomiting, diarrhoea, altered sensorium and jaundice. Out of 78 patients, one patient died due to enteric encephalopathy and other due to septicaemia with peripheral circulatory failure. 12 patients responded to chloramphenicol and gentamycin. 51 patients responded to ciprofloxacin, while remaining 9 patients responded to combination of cefotaxime and amikacin. Three patients showed in vitro resistance to ciprofloxacin and two out of these also showed no response in vivo. This study re-emphasises the changing pattern, prolonged course and role of quinolones especially ciprofloxacin in the management of drug resistant typhoid fever, but at the same time indicates that ciprofloxacin is not the drug of choice in all cases of typhoid fever and resistance to it may be seen in some cases, where other drugs have to be used.