Changing antibiotic sensitivity pattern and scope of chloramphenicol in the management of hospitalised patients of typhoid fever.

Enteric fever is a global health problem and there is emerging drug resistance with some reports of re-emerging sensitivity to previously used antibiotics eg, chloramphenicol. This study was done to compare the drug sensitivity pattern of enteric fever over a decade period. Twenty-five culture positive patients for S typhi from one study done between October 1993 to February 1995 and 35 positive patients from another study done between September 2005 and August 2006 in the same hospital were taken into account and their sensitivity pattern was compared. A total of 36% of cases were sensitive to all the drugs and equal number were multidrug resistant in the study in 1995, while in 2006 only 14.2% (p<0.05) were sensitive to all drugs and percentage of multidrug resistance has increased to 42% (p>0.05). Sensitivity to chloramphenicol had decreased from 68.00% to 54.30% (p>0.05). With the emergence of resistant strains there is significant decline in overall sensitivity to all first line drugs. However there is no change in chloramphenicol sensitivity of Salmonella enterica serovar typhi 10 years back and now, this alone is not the sufficient reason for reintroduction of this drug especially in younger patients.