Publication: Changing spectrum of antibiotic sensitivity in enteric fever
Date
2008
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Kathmandu University
Abstract
Abstract
Aims and objectives: The study was designed to analyze clinical profile and Antibiotic sensitivity pattern in case of
culture positive typhoid fever and compare response of quinolones in vitro and in vivo.
Methodology: Forty eight cases of culture positive enteric fever presented in outpatient and emergency department
of Kathmandu Medical College, Sinamangal, and Kathmandu were included in the study. Sensitivity pattern of
isolates from blood culture was done by antibiotic disc diffusion method and this was compared with clinical
response.
Results: Response was based on Fever Clearance Time (FCT) and it was found that mean FCT was 3.58 days with
standard deviation of 1.84 .Comparison was made separately for FCT ≥5 days and it was found that vomiting as the
symptom and stool occult blood positive as the investigation to predict prolong FCT. Nalidixic acid as compared
with other quinolones showed that other quinolones (ciprofloxacin, ofloxacin) are effective even in Nalidixic acid
resistant cases when FCT was taken as the criteria of response, and it doesn’t include the relapse rate.
Conclusion: Enteric fever is one of the leading causes of fever in Nepal. The diagnosis in most of the cases is done
empirically by clinical features, but culture and sensitivity of blood or bone marrow is the gold standard way of
diagnosis and providing treatment. The antibiotic sensitivity pattern is changing and resistance cases are emerging
with indiscriminate use of drugs.
Key words: Enteric fever, Salmonella typhi, fever clearance time (FCT), antibiotic sensitivity test (AST)
Description
Neopane A1, Singh SB2, Bhatta R2, Dhital B2, Karki DB3
1Associate Professor, 2Medical Officers, 3Prof. Department of medicine