A HIGHLY CEFTRIAXONE-RESISTANT SALMONELLA TYPHI IN BANGLADESH

Enteric fever continues to be a public health problem in the Indian subcontinent including Bangladesh. In the early 1990s there were many reports about the increasing frequency of multiresistant strains of Salmonella typhi.1, 2 All these reports prompted the suggestion that ciprofloxacin1 or ceftriaxone3 should be the empiric treatment of choice for enteric fever. This suggestion and the availability of ciprofloxacin and ceftriaxone have drastically reduced the use of first line drugs [amoxicillin, trimethoprim-sulfamethoxazole (TMP-SMX) and chloramphenicol] and led to a significant decrease of multiresistant S. typhi strains in Bangladesh.4 However, because of the contraindication of fluoroquinolone use in children and reports about epidemics with ciprofloxacin-resistant strains,1, 5 ceftriaxone become the drug of choice for treatment of these patients, if…