Can We Restart the First-Line Antibiotic as Empirical Choice When Enteric Fever is Suspected?

Enteric fever is a major health problem in Bangladesh. Antibiotic resistance especially against first-line antibiotics is a major concern in the management and thereby not practicing by physician as first choice thinking their resistance. This retrospective study was carried out in the Department of Microbiology, Bangladesh Medical College Hospital, Dhaka, Bangladesh from January of 2017 to December of 2019 to identify the year wise sensitivity pattern of first-line antibiotics like Amoxycillin, Cotrimoxazole and Chloramphenocol against Salmonella typhi and Salmonella paratyphi. All the blood samples sent for culture and sensitivity were evaluated to see the microbiom and their sensitivity pattern. Salmonella typhi and paratyphi were the major isolates in last 3 years which were 73.74% and 15.32% respectably. Sensitivity pattern of Amoxycillin, Cotrimoxazole and Chloramphenocol for Salmonella typhi is increased from 2017 to 2019 which were 66.0 to 83.0%, 80.0 to 83.0% and 84.0 to 85.0% respectively. Similar increasing pattern of sensitivity found in Salmonella paratyphi which was 82.5 to 89.2%, 76.2 to 95.4%, 98.7 to 98.5% respectively. They were also found highly sensitive (>90.0%) to 3rd generation cephalosporin. This study recommends the use of first-line antibiotics as empirical agent of choice in enteric fever as they are still highly sensitive against Salmonella typhi and Salmonella paratyphi.