Enteric Fever Treatment Failures: A Global Concern

Chandel, Dinesh S.; Chaudhry, Rama

doi:10.3201/eid0704.010436

Cited by 19 publications

(21 citation statements)

References 9 publications

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“…This observation is in accordance with the findings of Chandel et al [16], who reported that treatment failures did not always correlate with higher MICs to nalidixic acid and ciprofloxacin alone. Their findings suggest that, despite prolonged doses of ciprofloxacin, treatment failures are common with isolates sensitive to ciprofloxacin and nalidixic acid.…”

Section: Discussionsupporting

confidence: 93%

Reemergence of Chloramphenicol Sensitivity in Enteric Fever

Bhatia

Mathur

Arora

2007

Medical Journal Armed Forces India

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Background: Enteric fever is a global health problem and rapidly developing resistance to various drugs makes the situation more alarming. Drug sensitivity in Salmonella enterica serovar typhi and Salmonella enterica serovar paratyphi A isolated from 45 blood culture positive cases of enteric fever was tested to determine in-vitro susceptibility pattern of prevalent strains in northern India. Methods: Strains isolated from 45 blood culture positive cases of typhoid and paratyphoid fever over a period of three years were studied and their sensitivity patterns to chloramphenicol, ampicillin, ciprofloxacin, ceftriaxone, nalidixic acid, amikacin and ofloxacin were analysed. Results: Our results show a high sensitivity of both Salmonella enterica serovar typhi (96%) and Salmonella enterica serovar paratyphi A (100%) to chloramphenicol. Sensitivity to ciprofloxacin and amikacin was 88% and 84% respectively. All the isolates were sensitive to ofloxacin, nalidixic acid and ceftriaxone. Sensitivity of Salmonella enterica serovar paratyphi A was 100% to chloramphenicol, ciprofloxacin, ofloxacin, nalidixic acid and ceftriaxone, 95% to amikacin and 30% to ampicillin. Overall 44 out of 45 isolates of Salmonellae were sensitive to chloramphenicol. Conclusion: These findings suggest changing pattern of antibiotic resistance in enteric fever with reemergence of chloramphenicol sensitivity in northern India. MJAFI 2007; 63 : 212-214

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Section: Discussionsupporting

confidence: 93%

Reemergence of Chloramphenicol Sensitivity in Enteric Fever

Bhatia

Mathur

Arora

2007

Medical Journal Armed Forces India

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“…The Indian subcontinent and the southeast Asian countries are particularly affected by Multidrug Resistant (MDR) SamonellaTyphi strains. A clinical resistance to fluoroquinolones has also been reported [3,4]. So, in this brief review, we will be discussing the global problem of the increasing antimicrobial resistance in the typhoidal Salmonellae, which is a phenomenon of great importance in narrowing the therapeutic options in the treatment of typhoid fever.…”

Section: Introductionmentioning

confidence: 99%

Increasing Antimicrobial Resistance and Narrowing Therapeutics in Typhoidal Salmonellae

Kaurthe¹

2013

JCDR

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“…Mounting clinical evidence suggests that infections due to serovar Typhi and nontyphoidal strains resistant to nalidixic acid but susceptible to ciprofloxacin by NCCLS criteria may not respond to fluoroquinolone therapy (8,20,21,24,(31)(32)(33). While the reasons for treatment failure are multifactorial, PK-PD remains an important predictor of response to antimicrobial therapy, and failure to achieve adequate PK-PD targets may be a likely FIG.…”

Section: Discussionmentioning

confidence: 99%

Application of an In Vitro Infection Model and Simulation for Reevaluation of Fluoroquinolone Breakpoints for Salmonella enterica Serotype Typhi

Booker

Smith

Forrest

et al. 2005

Antimicrob Agents Chemother

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Salmonella enterica serotype Typhi and nontyphoidal Salmonella remain major causes of morbidity and mortality worldwide. Ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol no longer provide reliable coverage of Salmonella, and fluoroquinoloes have emerged as first-line treatment options. Due to mounting evidence of decreased in vitro susceptibility and diminished clinical response to fluoroquinolone therapy, it has been suggested that the NCCLS breakpoints for the salmonellae be reevaluated. We utilized an in vitro infection model to determine which pharmacokinetic-pharmacodynamic (PK-PD) measure was most closely linked to fluoroquinolone activity against salmonellae and the magnitude that was predictive of efficacy. Monte Carlo simulation was utilized to determine the probability of attaining potential susceptibility breakpoints for three fluoroquinolones. The free-drug area under the concentration-time curve from 0 to 24 h/MIC ratio was the PK-PD measure most predictive of efficacy, and a ratio of 105 corresponded to 90% of maximal activity. Simulation results suggested susceptible breakpoints of 0.12 g/ml for ciprofloxacin and gatifloxacin and 0.25 g/ml for levofloxacin. These proposed breakpoints correspond to the MIC separating the wild-type susceptible organism population from those strains possessing single-step mutations in the quinolone resistance-determining region. These results that integrate PK-PD measures and fluoroquinolone MIC distributions in the genetic context of examined Salmonella isolates clearly demonstrate that the prudent use of a lower susceptibility breakpoint minimizes the probability of clinical failure or delayed response in fluoroquinolonetreated patients.

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Enteric Fever Treatment Failures: A Global Concern

Cited by 19 publications

References 9 publications

Reemergence of Chloramphenicol Sensitivity in Enteric Fever

Reemergence of Chloramphenicol Sensitivity in Enteric Fever

Increasing Antimicrobial Resistance and Narrowing Therapeutics in Typhoidal Salmonellae

Application of an In Vitro Infection Model and Simulation for Reevaluation of Fluoroquinolone Breakpoints for Salmonella enterica Serotype Typhi

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