Reassessment of frequency of occurrence of typhoid fever and cost efficacy analysis of antibiotic therapy.

Typhoid fever has assumed importance due to the increased incidence of drug resistance in India. The exact magnitude of the problem is not accurately known. The objective of this study was to collect retrospectively the data on the incidence and frequency of typhoid fever among hospital admissions at St. Johns Medical College Hospital (SJMCH), Bangalore during the year 1987 to 1992 and also to study the sensitivity pattern and the use of antibiotics. The study was also aimed at comparison of immunogenicity and tolerance of conventional vaccine to the newer polysaccharide vaccine. It was found that the incidence of typhoid fever showed change from epidemic to endemic situation with outbreaks of epidemics. Sensitivity pattern also showed change during the same period and antibiotic resistance was increasingly demonstrated from 1989. Cost per patient and total cost to the hospital due to increased admissions also showed progressive increase. The polysaccharide vaccine (recently made available in India) had very low adverse reaction profile with higher immunogenicity as compared to conventional vaccine. Its single dose effect with long lasting immunity indicates it probable usefulness in the eradication of disease.