Karamat Ahmed Karamat, Karamat Ahmed Karamat, Tariq Butt, Abdul Hannan, Nasirul Islam, Tassawar Hussain, Ayaz Hussain Qureshi, Qamar R H.
Problem of Multi-Drug Resistant Typhoid Fever in Rawalpindi / Islamabad Area.
Pak Armed Forces Med J Jan ;46(2):48-54.

Typhoid fever is endemic in all the developing countries including Pakistan and emergence of multi-resistant S.typhi has added new dimension to the problem. All the 2551 isolates of typhoid salmonellae (S. typhi, n=2049 and S. paratyphi A, n=502) isolated during Jan 1987 and Dec 1995, were studied. Isolation of S. typhi resistant to conventional antityphoids i.e. chloramphenicol, ampicillin, cotrimoxazole, remained less than 10% till the end of 1989. Then multiresistant S. typhi siolated during subsequent years were increased; 1990 (65.94%), 1991 (56.32%), 1992 (49.42%), 1993 (56.9%) 1994 (66.67%) and 1995 (75.41%). No S. typhi was found resistant to fluoroquinolones (ciprofloxacin, & offoxacin) and third gereration cephalosporins (ceftriaxone & ceftizoxime). On the other hand, all the S. paratyphi A isolated were found susceptible to all the conventional antityphoids, fluoroquinolones and third gereration cephalosporins. We should recognize the problem of multiresistant S. typhi and expected danger of development of resistance against all the available antityphoid drugs. Our main stress should be towards prevention of the disease rather than for treatment.

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