1887

Abstract

The therapeutic alternatives available for use against ciprofloxacin-resistant enteric fever isolates in an endemic area are limited. The antibiotics currently available are the quinolones, third-generation cephalosporins and conventional first-line drugs. In this study, the MICs of various newer drugs were determined for 31 ciprofloxacin-resistant enteric fever isolates (26 serovar Typhi and 5 serovar Paratyphi A). MICs for ciprofloxacin, ofloxacin, gatifloxacin, levofloxacin, cefotaxime, cefixime, cefepime and azithromycin were determined using Etest strips and the agar dilution method. By Etest, all of the ciprofloxacin-resistant isolates had ciprofloxacin MICs ≥32 μg ml. Typhi showed MIC values of 0.50, 0.25 and 0.38 μg ml for cefixime, cefotaxime and cefepime, respectively. For the cephalosporins, a negligible difference in MIC and MIC values for Typhi and Paratyphi A was observed. A single isolate of Typhi showed a high azithromycin MIC of 64 μg ml. The MIC value for azithromycin in Typhi and Paratyphi was 24 μg ml. Gatifloxacin demonstrated lower resistance (80.8 %) compared with the other quinolones (92–100 %) in Typhi. The rise in MIC levels of these antimicrobials is a matter for serious concern.

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2007-11-01
2020-01-23
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