Enteric fever and changing trends in antimicrobial susceptibility pattern: Case series from a tertiary care hospital in Kerala

Enteric fever remains a major source of morbidity and mortality worldwide. Despite advances in therapy, the emergence of drug-resistant strains and their persistence confound this. The clinical profile of Salmonella infections and its drug susceptibility varies between geographical regions and countries, attributable to inadequate hygiene, and sanitation as a common factor. In this article, we describe a series of seven cases of enteric fever due to Salmonella Typhi and Salmonella Paratyphi A, which were diagnosed at a tertiary care hospital in Kerala with the purpose of identifying their antibiotic sensitivity pattern. Ceftriaxone is presently considered as the drug of choice due to increasing fluoroquinolone resistance. Oral Azithromycin remains a good substitute. Decreasing multidrug-resistant strains and increase in susceptibility to Ampicillin, Chloramphenicol, and Cotrimoxazole were noted. These changing trends highlight the need for better preventive measures, including proper sanitation and judicious use of antibiotics, adhering to correct dosage and duration, rather than searching for novel treatment options. Vaccination should be ideally promoted in endemic areas.