Decreasing clinical response of quinolones in the treatment of enteric fever.

Multidrug resistant Salmonella infections in India have been encountered since 1990, for which Quinolones were introduced at that time. However, with indiscriminate use of Quinolones, the sensitivity of these drugs when used alone, to treat S. typhi and S. paratyphi are decreasing. From 1997 to 1999, we have noted a gradual decrease in clinical efficacy of Quinolone monotherapy in enteric fever (9.3% in 1997, 20% in 1998 and 34.88% in 1999). Hence we recommend the use of multidrug therapy for Quinolone resistant and complicated enteric fever. Addition of Ceftriaxone and/or Aminoglycoside is recommended.