| ORIGINAL ARTICLE |
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| Year : 2012 | Volume
: 30
| Issue : 1 | Page : 30-33 |
Rationale of azithromycin prescribing practices for enteric fever in India
S Rai1, S Jain2, KN Prasad2, U Ghoshal2, TN Dhole2
1 Department of Microbiology, UCMS and GTB Hospital, Dilshad Garden, Delhi - 110 095, India
2 SGPGIMS, Raebareli Road, Lucknow - 226 014, India
Correspondence Address:
S Rai
Department of Microbiology, UCMS and GTB Hospital, Dilshad Garden, Delhi - 110 095
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0255-0857.93017
Purpose: The present study was performed to assess the current susceptibility pattern of blood isolates of Salmonella spp from a super specialty hospital in North India against nalidixic acid, ciprofloxacin and azithromycin and compare the in vitro and in vivo response against azithromycin. Materials and Methods: We evaluated the minimum inhibitory concentration's (MIC's) of 107 blood isolates of Salmonella spp against nalidixic acid, azithromycin and ciprofloxacin and correlated in vitro and in vivo response of azithromycin from the treatment and discharge summaries from the Hospital Information System (HIS) software. Results: Among the 107 isolates evaluated, 94 (87.8%) were nalidixic acid-resistant (NAR) Salmonella and 36 were resistant to azithromycin by MIC testing. The MIC 90 value for azithromycin was 24 μg/mL. Among the 57 treatment histories evaluated using the HIS software, 19 (33%) patients had documented clinical non-response to azithromycin which required change of therapy. Conclusions: The present study observed a higher MIC 90 values for azithromycin compared to Salmonella isolates from Western studies. There was also a documented clinical non-response against azithromycin. The in vitro and in vivo findings in this study suggest a guarded use of azithromycin for cases of enteric fever in India. The study also augments the reversal of resistance pattern in favour of chloramphenicol, ampicillin and trimethoprim - sulfamethoxazole.
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