Changing trend of antibiotic susceptibility pattern of Enteric Fever: What is Next?

Abstract

Enteric fever continues to be a major global public health problem, predominantly in the developing countries, including Bangladesh. Mortality rates due to enteric fever can be reduced from 30% to <1% by providing effective antimicrobial therapy which is facing challenges due to emerging antimicrobial resistance. The changing trend of antibiotic susceptibility pattern of Enteric fever from pre-antibiotic era through susceptible antibiotics, then multidrug resistance (MDREF) followed by re-emergence of sensitivity to some older resistant antibiotics pose therapeutic challenges for the physicians. The purpose of this review article is to compare the antibiogram of Salmonella isolates of different recent studies and analyzing the changing trend of antibiotic resistance pattern for further successful management. This may also enable planning of antibiotic recycling wherever feasible.
 J MEDICINE JAN 2020; 21 (1) : 51-54

Chloramphenicol is re-emerging as an effective drug in the treatment of typhoid fever in Southern Benue state, Nigeria

“…Also, Islam et al [34] reported in a study conducted in Bangladesh that only 28 (32.5%) out of 86 S. typhi isolates showed resistance to chloramphenicol, suggesting more susceptibility than resistance. Similarly, in a review of 6 different studies conducted in different countries of the world including Bangladesh, Ahasan et al [35] reported increasing susceptibility of salmonella isolates to the first line antibiotics chloramphenicol, ampicillin and cotrimoxazole. Ayalu et al [8] and Baya et al [10] however, reported resistance to chloramphenicol in their findings.…”

“…Our findings revealed that chloramphenicol is currently not commonly prescribed in the study area. Suspending the use of an antibiotic to which resistance has developed over a period, could reverse the trend, and restore its effectiveness by the elimination of selective pressure [1,35]. Also, the increase in susceptibility of S. typhi to chloramphenicol as observed in this study could have resulted from the emergence of new susceptible strains and the loss of selftransmissible, high molecular weight plasmids by the bacterium [36].…”