In vitro susceptibility of typhoidal Salmonellae against newer antimicrobial agents: a search for alternate treatment options

J Pak Med Assoc. 2011 May;61(5):462-5.

Abstract

Objectives: To determine the minimum inhibitory concentrations (MICs) of ceftriaxone, azithromycin, pefloxacin, cefipime and imipenem for Salmonella Typhi (S. Typhi) and Paratyphi.

Methods: One hundred and fifty four isolates of Salmonella Typhi and S. Paratyphi A, B and C growing in blood culture were selected. MICs of ceftriaxone, azithromycin, pefloxacin, cefipime and imipenem were performed by agar dilution method as recommended by clinical laboratory standard institutes.

Results: MIC90 of azithromycin and pefloxacin was 8 microg/ml, cefipime was 0.06 microg/ml and imipenem was 0.5 microg/ml. None of the strains were found to be resistant to ceftriaxone but 3 isolates showed higher MIC value of 2 microg/ml.

Conclusion: Azithromycin appears a suitable alternate for the treatment of typhoid in the community. Imipenem and cefipime are good options in complicated cases to be treated in hospital settings. Pefloxacin cannot be used as MICs are higher. Presence of isolates with higher MIC of ceftriaxone is serious and stresses upon continuous laboratory surveillance to guide clinicians appropriately.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Drug Resistance, Multiple, Bacterial
  • Humans
  • Microbial Sensitivity Tests
  • Paratyphoid Fever / drug therapy*
  • Paratyphoid Fever / microbiology
  • Salmonella paratyphi A / classification
  • Salmonella paratyphi A / drug effects*
  • Salmonella paratyphi A / isolation & purification
  • Salmonella typhi / drug effects*
  • Salmonella typhi / isolation & purification
  • Typhoid Fever / drug therapy*
  • Typhoid Fever / microbiology
  • Young Adult

Substances

  • Anti-Bacterial Agents