Mohammad Imran, Fazalur Rahman Khan, Asmat Ara Khattak, Aurang Zeb, Liaqat Ali.
Multi drug - resistant Enteric Fever in children.
Pak Paed J Jan ;20(4):169-73.

This study on drug resistance in enteric fever was carried out in Paediatric "A" Unit. Postgraduate Medical Institute/Lady Reading Hospital. Peshawar from March 1993 to February 1994. Inclusion criterion was positive blood and/or bone marrow, culture. In total, 50 patients had positive culture for salmonella (blood in 26 patients and bone marrow in 49 patients). Organism isolated were salmonella typhi in 49 cases and salmonella paratyphi A in one case. The single isolate of S paratyphi A was sensitive to all the antimicrobials tested except cotrimoxazole. Out of 49 isolates of S typhi only 5 (10.2%) were sensitive to all the primary anti-typhoid antimicrobials, while 44 (89.8%) were resistant to multiple drugs. All of the isolates here fully sensitive to ciprofloxacin and ofloxacin, while sensitivity to third generation cephalosporins varied between 57% and 79%. Inspite of in vitro resistance. 22 patients (44%) showed good clinical response to amoxycillin and chloramphenicol. In the remaining 28 patients (56%) response to the above drugs was poor, and they were started on ofloxacin (in children above 5 years of age) or third generation cephalosporins. Response of the patients to these drugs was good with defervescence within 8 days after start of treatment No significant untoward effects of quinolones were noted in these children. We conclude that quinolones can be used in children above 5 years of age in multidrug - resistant typhoid fever.

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