Faqir Farah, Abdul Sattar, Alizai Shela Ambreen, Satti Masood, Javaid Asghar, Shahid Ahmad Abbasi.
In vitro Efficacy of Azithromycin against Salmonella typhi.
Infect Dis J Jan ;21(2):427-9.

With the emergence of multidrug resistant and reduced susceptibility of Salmonella typhi isolates to fluoroquinolones and resultant treatment failure in enteric fever patients, there is an urgent need to establish alternative antibiotic treatment. Azithromycin has shown promise in treatment of typhoid fever. This study was aimed at detecting in vitro efficacy of azithromycin against multidrug resistant and nalidixic acid resistant Salmonella typhi in our set up. Methodology: This study was conducted at the department of Microbiology, Army Medical College, Rawalpindi from December 2006 through August 2008. Salmonella typhi was isolated by routine microbiological methods from blood cultures. Susceptibility was determined by standard disc diffusion method. For minimum inhibitory concentration E-strips of azithromycin were used. Results: A total of sixty two Salmonella typhi isolates were included. Isolates sensitive to first line antibiotics were 28(45.2%), multidrug-resistant but nalidixic acid sensitive were 6 (9.7%), multidrug-resistant and nalidixic acid resistant 2 (3.2%), and only nalidixic acid resistant 26 (41.9%). Minimum inhibitory concentration of Azithromycin for all isolates was in the sensitive range i.e. below 16µg/ml. The mean minimum inhibitory concentration of the isolates sensitive to the first line antibiotics was 2.5µg/ml whereas for the multidrug-resistant & nalidixic acid resistant isolates it was 3.3µg/ml. Conclusion: Our study showed an increase in the minimum inhibitory concentration of the multidrug-resistant and nalidixic acid resistant Salmonella typhi isolates. Azithromycin can be beneficial in the treatment of enteric fever caused by multidrug-resistant and nalidixic acid resistant isolates of Salmonella typhi.

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