Changing Spectrum of Antibiotic Sensitivity in Enteric Fever- A Six Year Retrospective Study in North India

Enteric fever is a global health problem and rapidly developing resistance to various drugs makes the situation more alarming. Drug sensitivity in Salmonella typhi and Salmonella paratyphi A isolated from 136 blood culture positive cases of enteric fever was tested to determine in-vitro susceptibility pattern of prevalent strains in Northern India. To study the changing spectrum of antibiotic sensitivity in enteric fever. Strains isolated from 136 blood culture positive cases of typhoid and paratyphoid fever over a period of six years were studied and their sensitivity patterns to chloramphenicol, ampicillin, cotrimoxazole, ciprofloxacin, ceftriaxone, cefotaxime, cephalexin, nalidixic acid, amikacin, ofloxacin and azithromycin were analysed using SPSS version 15. A high sensitivity was observed to chloramphenicol for both Salmonella typhi (98.9%) and Salmonella paratyphi A (100%). All the isolateswere sensitive to amikacin and ceftriaxone. Sensitivity to ciprofloxacin, ofloxacin and cefotaxime was 97%, 99% and 99% respectively. Sensitivity of Salmonella paratyphi A was 100% tochloramphenicol, ciprofloxacin, ofloxacin, ceftriaxone and amikacin, 85% to cotrimoxazole, 68% to ampicillin and only 14% to nalidixic acid. In our practice, it was observed that there is a changing pattern of antibiotic resistance in enteric fever with re-emergence of chloramphenicol sensitivity in Punjab. The policy of empirical treatment of enteric fever needs to be rationalized; since increasing rates of antibiotic resistance may ultimately render inexpensive antibiotics obsolete and make it necessary to use expensive newer antibiotics.