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TITLE:

CURRENT ANTIBIOTIC USE IN THE TREATMENT OF ENTERIC FEVER IN CHILDREN

AUTHORS:

Dr. Hafiz Muhammad Faisal Tehseen, Dr.Ayesha Saddiqa, Dr.Saira Shafee

ABSTRACT:

Context and objectives: antimicrobial resistance is a great challenge in the treatment of typhus, with a limited choice for the empirical treatment of these patients. The present study was conducted to identify current antibiotic use practices among children visiting a tertiary care hospital in Lahore Methods: This was a descriptive observational study in children with enteric fever as defined by the case, including clinical and laboratory parameters. The antibiotic audit in hospitalized children was measured as days of therapy for 1000 days of patients and in ambulance (OPD) as a prescription of antibiotics on the treatment sheet. Results: 128 children with intestinal fever were included in the study, 30 of whom were hospitalized and 98 were treated with OPD. The average duration of fever at the time of presentation was 9.5 days. Of these, 45 percent were culture positive, with 68 percent Salmonella Typhi as the causative agent, followed by S. Paratyphi A in 32 percent. During the hospital stay, the average length of stay was 10 days with an average duration of 6.4 days. Based on antimicrobial susceptibility, ceftriaxone was administered to 28 patients with a mean treatment duration of six days. In six patients, an additional antibiotic was needed because the clinical response had failed. In OPD, cefixime was prescribed to 79 patients and in five patients an additional antibiotic was needed during follow-up. Interpretation and conclusions: based on our results, ceftriaxone and cefixime appeared to be the first line of typhoid antibiotic therapy. Despite the susceptibility, a lack of clinical response was observed in about 10 percent of patients requiring antibiotic combinations. Key words Antibiotic use - days of therapy - enteric fever - Salmonella Typhi

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