Frequency of antibiotic resistance in enteric fever both naïve and treated patients in our population.

Abstract

Objective: To assess the antibiotic resistance in enteric fever in our population. Study Design: Observation study. Setting: OPD and indoor patients in three tertiary care hospitals of Lahore. Period: May 2018 to September 2018. Material & Methods: We selected patients with symptoms and signs of enteric fever randomly in our out door and ER departments. Blood cultures were sent before start of any antibiotic. Patients with Positive culture were enrolled for this study. Results: We enrolled 180 patients, including 123 (68.3%) male patients and 57 (31.7%) were female patients. We divided these patients in three groups, below 25 years 38(21.1%) patients, from 26 to 50 years 98(54.4%), and above 50 years 44(24.4%) patients. Out of 180 patients 138(76.7%) patients took antibiotic before coming to us, 42 (23.3%) were naïve patients. We found 108 (60%) patient having quinolone resistance and 72 (40%) were sensitive to floroquinolones, 88 (48.9%) patients were cephalosporin resistant and 12 (6.7%) were macrolide resistant. We did not check the sensitivity of chloramphenicol, ampicillin and nalidixic acid as it is already proven resistance of these antibiotics. Among all patients quinolones resistance was much higher and resistance against cephalosporin is also increasing and few cases were found to be resistant to even macrolides, although resistance against macrolides is low up to now. Conclusion: Antibiotic resistance is gradually increasing rapidly even against those drugs which were proven very effective against salmonella typhi and paratyphi infections. Younger population (26-50years) had much more resistance than below 25 and above 50 years patients. Due to such prevalence of antibiotic resistance, few antibiotics are left for the treatment of enteric fever, which lead not only to high morbidity and mortality in these patients but a great financial burden for developing countries like Pakistan. Patients with positive blood culture of salmonella were included in this study. Patients with other causes of fever, malaria, Tb, respiratory infections, and with negative blood culture.