Antibiotic Sensitivity Patterns in Pediatric Enteric Fever: A Cross-Sectional Study at a Tertiary Care Hospital in Bangladesh

Md. Atiqul Islam; Sheuly Begum; Mohammad Mostafizur Rahman; Md.Mizanur Rahaman; AKM Tajuddin Bhuiyan

doi:10.61561/ssbj.v4i3.38

Authors

Md. Atiqul Islam Assistant Professor, Dept. of Paediatrics, Bangladesh Institute of Child Health, Dhaka Shishu (Children) Hospital.
Sheuly Begum Associate Professor, Dept. of Gynaeocology & Obstetrics, Enam Medical College, Savar, Dhaka, Bangladesh
Mohammad Mostafizur Rahman Associate Professor & Head, Dept of Anesthesiology &ICU, Ashiyan Medical College Hospital, Barua, Khilkhet Dhaka, Bangladesh.
Md.Mizanur Rahaman Associate Professor, Dept. of Paediatrics, Bangladesh Institute of Child Health, Dhaka Shishu (Children) Hospital.
AKM Tajuddin Bhuiyan Register, Bangladesh Institute of Child Health & Dhaka Shishu (Children) Hospital.

DOI:

https://doi.org/10.61561/ssbj.v4i3.38

Keywords:

Antibiotic Sensitivity Patterns, Pediatric Enteric Fever, Antibiotic Sensitivity, Enteric Fever

Abstract

Background: This cross-sectional study aimed to investigate the antibiotic sensitivity patterns among pediatric patients with enteric fever at the Department of Paediatrics, Bangladesh Institute of Child Health, Dhaka Shishu Hospital, during the period from July 2005 to June 2006. The primary objective was to identify the prevalent antibiotic sensitivities in order to enhance the efficacy of treatment strategies for typhoid fever in children. Methods: Ninety-eight suspected cases of enteric fever, aged between 2 and 12 years, were selected from admissions to the above-mentioned hospital. Blood culture and sensitivity testing were performed for Salmonella typhi and paratyphi. Demographic information, pre-admission antibiotic usage, and sensitivity profiles to various antibiotics, including Ceftriaxone, Cefixime, Chloramphenicol, Ciprofloxacin, Azithromycin, Amoxicillin, Imipenem, Nalidixic acid, and Ampicillin, were analyzed. Results: The majority of patients (62.2%) were in the 5-9 years age group, and males constituted 61.22% of the study population. Blood cultures revealed 71.44% sensitivity for Salmonella typhi and 28.57% for paratyphi. Among the antibiotics tested, Ceftriaxone exhibited 100% sensitivity, followed by Cefixime (80.2%), Chloramphenicol (78.57%), Ciprofloxacin (65.20%), Azithromycin (60%), Amoxicillin (54.6%), Imipenem, Nalidixic acid (Intermediate sensitive, 56.3%), Ciprofloxacin (Intermediate sensitive, 25%), and Ampicillin (Intermediate sensitive, 18.8%). Nearly half of the patients (47.3%) received antibiotics before admission, and 43.8% of culture-positive patients had a history of pre-admission antibiotic use. Conclusion: The study concludes that understanding antibiotic sensitivity patterns is crucial for successful typhoid fever treatment in children. Ceftriaxone and Cefixime emerged as highly effective, while the unnecessary use of antibiotics prior to admission may influence sensitivity patterns. This information underscores the importance of judicious antibiotic prescribing practices to ensure optimal therapeutic outcomes in pediatric enteric fever cases.

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References

Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ. 2004 May;82(5):346-53. PMID: 15298225; PMCID: PMC2622843.

Tulchinsky TH, Varavikova EA. A History of Public Health. The New Public Health. 2014:1–42. doi: 10.1016/B978-0-12-415766-8.00001-X. Epub 2014 Oct 10. PMCID: PMC7170188.

Salman Y, Asim H, Hashmi N, Islam Z, Essar MY, Haque MA. Typhoid in Bangladesh: Challenges, efforts, and recommendations. Ann Med Surg (Lond). 2022 Jul 31;80:104261. doi: 10.1016/j.amsu.2022.104261. PMID: 35958285; PMCID: PMC9358424.

Bennadi D. Self-medication: A current challenge. J Basic Clin Pharm. 2013 Dec;5(1):19-23. doi: 10.4103/0976-0105.128253. PMID: 24808684; PMCID: PMC4012703.

Dyson ZA, Klemm EJ, Palmer S, Dougan G. Antibiotic Resistance and Typhoid. Clin Infect Dis. 2019 Mar 7;68(Suppl 2):S165-S170. doi: 10.1093/cid/ciy1111. PMID: 30845331; PMCID: PMC6405283.

Amsalu T, Genet C, Adem Siraj Y. Salmonella Typhi and Salmonella Paratyphi prevalence, antimicrobial susceptibility profile and factors associated with enteric fever infection in Bahir Dar, Ethiopia. Sci Rep. 2021 Apr 1;11(1):7359. doi: 10.1038/s41598-021-86743-9. PMID: 33795754; PMCID: PMC8016905.

Bhandari J, Thada PK, DeVos E. Typhoid Fever. [Updated 2022 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK557513/

Chanda W, Manyepa M, Chikwanda E, Daka V, Chileshe J, Tembo M, Kasongo J, Chipipa A, Handema R, Mulemena JA. Evaluation of antibiotic susceptibility patterns of pathogens isolated from routine laboratory specimens at Ndola Teaching Hospital: A retrospective study. PLoS One. 2019 Dec 23;14(12):e0226676. doi: 10.1371/journal.pone.0226676. PMID: 31869354; PMCID: PMC6927611.

Kalra SP, Naithani N, Mehta SR, Swamy AJ. Current Trends in the Management of Typhoid Fever. Med J Armed Forces India. 2003 Apr;59(2):130-5. doi: 10.1016/S0377-1237(03)80060-6. Epub 2011 Jul 21. PMID: 27407487; PMCID: PMC4923770.

Baym M, Stone LK, Kishony R. Multidrug evolutionary strategies to reverse antibiotic resistance. Science. 2016 Jan 1;351(6268):aad3292. doi: 10.1126/science.aad3292. PMID: 26722002; PMCID: PMC5496981.

Salam MA, Al-Amin MY, Salam MT, Pawar JS, Akhter N, Rabaan AA, Alqumber MAA. Antimicrobial Resistance: A Growing Serious Threat for Global Public Health. Healthcare (Basel). 2023 Jul 5;11(13):1946. doi: 10.3390/healthcare11131946. PMID: 37444780; PMCID: PMC10340576.

Shariati A, Arshadi M, Khosrojerdi MA, Abedinzadeh M, Ganjalishahi M, Maleki A, Heidary M, Khoshnood S. The resistance mechanisms of bacteria against ciprofloxacin and new approaches for enhancing the efficacy of this antibiotic. Front Public Health. 2022 Dec 21;10:1025633. doi: 10.3389/fpubh.2022.1025633. PMID: 36620240; PMCID: PMC9815622.