Antibiotic pattern in enteric fever, in children

ABSTRACT

To determine the treatment response with first line and second line antibiotics in blood culture positive children of enteric fever, in our setup. This prospective cross-sectional, observational study was carried out from January 2007 to December 2007 in the Departments of Paediatrics and Pathology, Peoples Medical College Nawabshah. A total of 65 blood culture positive patients for salmonella typhi having ages ranged between 2-12 years including 40 [61.5%] male and 25 [38.5%] female patients. Five treatment regithens were designed as first and second line antibiotics, and patients were started on any one of first line regimen haphazardly. Response to treatment was observed by improvement in symptoms and settling of fever, if temperature did not settle in 6 days of commencing treatment, the antibiotic was changed. Patient who responded to initial treatment were treated with the same drug for 14 days. Fever with abdominal pain was the commonest clinical presentation. Typhidot was positive in 60 [92.3%] patients and widal test in 49 [75.4%] patients. 48 [73.8%] patients improved with the first line treatment and 17 [26.2%] patients who were not responding to first line treatment were switched to other treatment. The present study highlights the importance of second line antibiotics in treating enteric fever, as there is increasing resistance to first line antibiotics in children so it is better to start with second line antibiotics as culture positive in enteric fever is not more than 50%