Case of Extensively Drug-Resistant (XDR) Typhoid with Resistance to Azithromycin
DOI:
https://doi.org/10.51985/Keywords:
Azithromycin, Extensive Drug-Resistance (XDR), Salmonella Typhi, Typhoid feverAbstract
An 18-year-old boy from Haripur, Pakistan was diagnosed with extensively drug-resistant (XDR) typhoid fever after presenting with acute febrile illness. Blood culture confirmed the isolates of Salmonella Typhi. Antimicrobial susceptibility testing revealed that the isolates were extensively drug-resistant (XDR) to all the first line antibiotics in addition to azithromycin. Only a few antibiotics such as meropenem, colistin and tigecycline were found effective against the bacterium. Empirical therapy with a first line antibiotic failed to treat the infection. After the antimicrobial susceptibility report, the patient was managed successfully with a costly course of meropenem. Azithromycin and carbapenem are the two antibiotics that are recommended to treat XDR typhoid fever. Therefore, resistance to azithromycin is a worrying sign, limiting the treatment options against XDR typhoid, and increasing the cost of therapy as well as the complications.
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