A STUDY ON CLINICAL PROFILE AND LABORATORY PROFILE CHANGES OF ENTERIC FEVER

2021 ◽  
pp. 45-47
Author(s):  
Krushna Chandra Das ◽  
Debarshi Jana
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Prospective Observational Study ◽  
Widal Test ◽  
Elevated Liver Enzymes ◽  
Sensitivity Pattern ◽  
Profile Changes ◽  
Laboratory Profile ◽  
Culture Positive ◽  
Common Laboratory

AIM:The aim of the study is to asses study the clinical and laboratory prole. Culture positive & sensitivity pattern of Salmonella enteric and its response to antimicrobial therapy admitted in SSKM Hospital in Kolkata. MATERIAL AND METHOD: This is a prospective, observational study of paediatric aged between 5-12 years who are admitted in SSKM Hospital in Kolkata, West Bengal, India during the period of Sep 2016- Sep2018 the study includes 104 pediatric who were suffering from Enteric fever.RESULT:We found that 22(21.2%) patients had lymphadenopathy, 83(79.8%) patients had positive widal test (O antigen), 18(17.3%) patients had positive widal test (H antigen) and 42(40.4%) patients had positive blood culture. According to blood culture, 5(4.8%) patients had S.para typhi and 36(34.6%) patients had S.typhi. CONCLUSION: Leucopenia, eosinopenia and mildly elevated liver enzymes are common laboratory ndings. Widal is though a good screening test but has poor specicity for diagnosing culture positive enteric fever cases.

Comparison of the performance of Tubex® TF, widalimmunodiagnostic assay and blood culture in diagnosis of enteric fever in a private tertiary care hospital Peshawar, Pakistan

2020 ◽  
pp. 1-8
Author(s):  
Kamran Amir Khan ◽  
Sameed Ullah Qureshi ◽  
Shumaila Ehtisham ◽  
Admin
Keyword(s):  
Blood Culture ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Research Centre ◽  
Care Hospital ◽  
Widal Test ◽  
Culture Positive

Abstract Objective: To determine and compare the performance of TUBEX® TF, widal test & blood culture in the diagnosis of enteric fever. Methods: After approving with the ethical committee, we retrospectively identified patients presented with fever at Northwest General Hospital and Research Centre. Typhidot, Widal test and blood culture was performed as part of their evaluation from January 2018 to December 2018. SPSS 16 was used for data analysis. Results: Of the 241 patients, blood culture was positive for salmonella in 68(28.21%) and negative in 173(71.79%). In the culture positive group, TUBEX® TF was positive in 29(42.64%) and negative in 39(57.36%). Of these culture positive patients, Widal was positive in 25(36.76%) and negative in 43(63.24%). In patients with negative culture, TUBEX® TF was positive in 58(37.66%) and negative in 96(62.34%), Widal was positive in 77(44.5%) and negative in 96(55.5%). The positive predictive value of TUBEX® TF was 33.33% and the negative predictive value was 71.77%. The sensitivity of TUBEX® TF was 42.65% while specificity was 62.34%. The positive predictive value of Widal was 24.51% and the negative predictive value was 69.06%. The sensitivity of Widal was 36.76% while specificity was 55.49%. Conclusion: Sensitivity, specificity, positive predictive value and negative predictive value of TUBEX® TF and Widal test is very low as compared to blood culture. Keywords: Enteric Fever, TUBEX® TF, Widal, Continuous...

scholarly journals Blood Culture and Widal Test as Diagnostic Tools for Enteric Fever with Antibiogram in a Tertiary Care Centre at Dhaka in Bangladesh

2021 ◽  
pp. 97-106
Author(s):  
Sushmita Roy ◽  
Iftikhar Ahmed ◽  
Provash Chandra Saha ◽  
Bhuiyan Mohammad Mahtab Uddin ◽  
Mejbah Uddin Ahmed ◽  
...  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Antibody Titer ◽  
Antibiotic Susceptibility ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Diagnostic Methods ◽  
Diagnostic Tools ◽  
Widal Test ◽  
Sensitivity Pattern

Background: Enteric fever still exists as one of the major public health issue occurring in our country. Antimicrobials are the mainstays of treatment of typhoid fever. Due to rapidly growing antibiotic resistance, Salmonella spp. is required to be periodically tested for susceptibility patterns. This will also enable planning of rational use of antibiotics. Objective: To observe the diagnostic accuracy of enteric fever by blood culture and Widal test in a tertiary care center, at Savar, Dhaka; Bangladesh. Antimicrobial sensitivity pattern of this study will guide to modify recent changes in the trends of antimicrobial use at the local level. Methodology: Blood samples were collected from 2194 febrile patients with clinically suspected enteric fever cases at a Tertiary Care Outdoor Centre from January 2017 to March 2020. Blood culture was performed to isolate S. typhi and S. paratyphi. Widal tests were done for the determination of antibody titer. An antibody titer of ≥1:80 for anti TO and anti TH were taken as a cut off value to indicate recent infection of typhoid fever. Antibiotic susceptibility testing was carried out using modified disk diffusion (Kirby–Bauer) technique. Results: Out of 111 Salmonella isolates, 74 (5%) were S. typhi and 37 (25%) were S. paratyphi A.  Total 697 samples were positive for Widal test. A large number of isolates showed resistance to commonly used antibiotics such as nalidixic acid (94.6%), chloramphenicol (87.3%), amoxicillin (76.6%), cephradine (53.1%), azithromycin (46.8) etc. Resistance to cefixime and cefipime, ceftriaxone tended to increase than past. Imipenem, moxifloxacin and cefuroxime are escalating resistance which is alarming. Conclusion: Blood culture is the most reliable among the diagnostic methods but it needs 5 to 7 days for delivery of final report. This delay leads to late diagnosis as well as provision of irrational usage of antibiotics. It is concluded that widal test would remain relevant as a diagnostic tool for enteric fever, which is more convenient, cheaper and faster than the other molecular tests. Our study revealed the antibiotic susceptibility of Salmonella isolates will be recommended for addressing the drug resistance.

ANTIMICROBIAL SUSCEPTIBILITY IN CULTURE POSITIVE ENTERIC FEVER

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Manish Kulshrestha ◽  
Dr. Anjali Kulshrestha
Keyword(s):  
Bone Marrow ◽  
Blood Culture ◽  
Nalidixic Acid ◽  
Antimicrobial Susceptibility ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Multidrug Resistant ◽  
Bone Marrow Culture ◽  
Diffusion Method ◽  
Culture Positive

INTRODUCTION: Enteric fever includes typhoid and paratyphoid fever. Peak incidence is seen in children 5–15 years of age; but in regions where the disease is highly endemic, as in India, children younger than 5 years of age may have the highest infection rates. There are about 22 million new typhoid cases occur each year. Young children in poor, resource limited areas, who make up the majority of the new cases and there is a mortality figures of 215,000 deaths annually. A sharp decline in the rates of complications and mortality due to typhoid fever is observed as a result of introduction of effective antibiotic therapy since 1950s. MDR-ST became endemic in many areas of Asia, including India soon after multidrug-resistant strains of Salmonella enterica serotype typhi (MDR-ST) that were resistant to all the three first-line drugs then in use, namely chloramphenicol, amoxycillin and co-trimoxazole emerged in early 1990s. MATERIAL AND METHODS: Only blood culture or bone marrow culture positive cases were included. The patients with culture isolated enteric fever were included in the study. Antimicrobial susceptibility testing was carried out by disk diffusion method using antibiotic discs. The analysis of the antimicrobial susceptibility was carried out as per CLSI interpretative guidelines. RESULTS: A total of 82 culture positive cases were included in the present study. 80 culture isolates were from blood culture and 2 from the bone marrow culture. Salmonella entericasubspecies enterica serovartyphi (S typhi) was isolated from 67 (81.70%) patients while Salmonella enterica subspecies entericaserovarparatyphi (S paratyphi A) was isolated from 13 (15.85%) cases and 2 (2.44%) were Salmonella enterica subspecies entericaserovarschottmuelleri (S paratyphi B). Of the 82 cases 65(79.3%) isolates were resistant to ciprofloxacin, 17 (20.7%) were resistant to nalidixic acid, one (1.2%) case each was resistant to Cefotaxime and ceftriaxone, 2 (2.4%) were resistant to chloramphenicol, 10 (12.2%) were resistant and to cotrimoxazole 3 (3.7%) were resistant. CONCLUSION: In a culture positive cases 65(79.3%) isolates were resistant to ciprofloxacin and 17 (20.7%) were resistant to nalidixic acid. Multidrug resistant isolates were 65(79.3%).

Antibiotic Sensitivity and Resistance Patterns of Salmonella Typhi in Rajshahi Medical College Hospital

2020 ◽  
Vol 33 (2) ◽  
pp. 10-14
Author(s):  
Md Azizul Haque ◽  
Laila Shamima Sharmin ◽  
KM Faisal Alam ◽  
Md Mohimanul Hoque ◽  
M Morsed Zaman Miah ◽  
...  
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Antibiotic Sensitivity ◽  
Salmonella Typhi ◽  
Medical College Hospital ◽  
Personal Hygiene ◽  
Care Hospital ◽  
College Hospital ◽  
Medical College ◽  
Sensitivity Pattern

Typhoid and paratyphoid fevers, collectively known as enteric fever, is caused by Salmonella enterica subspecies serovars Typhi and Paratyphi A, B and C. Despite this declining global trend, enteric fever is still considered to be a major public health hazard in Bangladesh and other developing countries due to poor sanitation, inadequate food safety measures and poor personal hygiene. In Bangladesh, the incidence of typhoid fever was reported to be 200 episodes per 100,000 person-years during 2003–2004. Multidrug-resistant (resistance to the first-line antimicrobials ampicillin, cotrimoxazole, and chloramphenicol) strains of S. Typhi and S. Paratyphi are on the rise globally and even cases of extensively drug-resistant (XDR) typhoid cases resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, third generation cephalosporins and fluoroquinolones are being reported from many corners of the world. This descriptive, observational study was carried out in Rajshahi Medical College Hospital Hospital, Rajshahi, Bangladesh from July 2017 to June 2019. Antibiotic sensitivity pattern of total 76 cases of enteric fever due to Salmonella Typhi were studied. Blood culture was carried out by BACT ALERT-3D, Automated blood culture analyzer from BioMeriuex SA, France Patented FAN Plus method. Based on the minimum inhibitory concentration (MIC), the organism was categorized as sensitive, intermediate, and resistant against the respective antibiotics as per Clinical and Laboratory Standards Institute (CLSI) criteria. We are reporting antibiotic sensitivity and resistant patterns of S. Typhi documented in Rajshahi Medical College Hospital, a large tertiary care hospital in Northern Bangladesh. TAJ 2020; 33(2): 10-14

scholarly journals CLINICAL PROFILE AND ANTIBIOTIC SENSITIVITY PATTERN OF ENTERIC FEVER AMONG CHILDREN ADMITTED IN PEDIATRICS DEPARTMENT OF JLNMCH, BHAGALPUR, BIHAR

2021 ◽  
pp. 1-3
Author(s):  
Mithilesh Kumar ◽  
R. K. Sinha ◽  
Debarshi Jana
Keyword(s):  
Enteric Fever ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Urban Slum ◽  
Case Definition ◽  
Clinical Profile ◽  
Suspected Case ◽  
Care Hospital ◽  
Widal Test ◽  
Sensitivity Pattern

Objective: In this study our main aims to know the clinical profile of pediatric enteric fever and the sensitivity pattern of the disease to drugs in this region. Methodology: This prospective observational study conducted in a tertiary care hospital at Dhaka from March to December 2019 among suspected case of Enteric fever as per case definition. Among 212 suspected enteric fever 117 children were diagnosed as enteric fever by blood culture and/or Widal test. Results: During the study, Male: female were 1.3: 1. Maximum (70%) children were in age group 5 years or more. Most of the children were from urban slum area (53.6%) of Dhaka city. Cases were admitted throughout the year. Common presentation were fever (100%), anorexia (100%), pain abdomen (74.4%) and loose motions (46.1%). The common signs were hepatomegaly (41.9%), hepatosplenomegaly (5.1%) coated tongue (64.9%), pallor (74.4%). The complications rate was 35.9% and commonest being UTI and pneumonia. The overall positivity of Widal test was 89.7% and the culture positivity was 32.5%. Among isolates, 94.7%were Salmonella typhi and 5.3% Salmonella paratyphi A. Among them18.1% isolates were multi drug resistant. Conclusion: Enteric fever is most prevalent during summer & rainy session. WASA supplied water may play a role. Hepatomegaly is common. UTI and pneumonia are the commonest complication. Multidrug resistant cases are not so as high as other countries. Cefixime, Ceftriaxone. Meropenam and Ofloxacine are the drugs of choice. Ciprofloxacin is still could be chosen for the treatment of enteric fever. Higher rate of resistant to Azithromycin is alarming.

scholarly journals Comparison of Antibody Titre Against Salmonella Species among Healthy Individuals and Febrile Patients

2018 ◽  
Vol 14 (3) ◽  
pp. 132-136
Author(s):  
Achut Barakoti ◽  
Junu Richhinbung Rai ◽  
Ram Prasad Adhikari ◽  
Laxmi Kant Khanal
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Significant Proportion ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Healthy Individuals ◽  
Cross Sectional ◽  
Resource Limited ◽  
Culture Positive ◽  
Apparently Healthy

Background: Widal tube agglutination test is a widely used laboratory test for diagnosis of enteric fever   especially in resource limited countries where blood culture are not routinely available. We studied the titres from different groups including febrile and healthy populations in order to identify the significant agglutination titre. Materials and Methods: This was a hospital based cross-sectional study. Subjects were divided into three groups: 1) 60 healthy blood samples from volunteer students, 2) 60 febrile non-typhoidal cases and 3) 58 culture positive patient for enteric fever. Results: Among 60 apparently healthy volunteers, agglutination of ≥ 1:20 for anti O and anti-H titres against serotype Typhi were seen in 40 and 46 samples respectively. A significant proportion of   sample had a titre of ≥1:80 (n=19) and 1:160 (n=14) for anti O and anti-H titres against serotype Typhi respectively among healthy individuals. Similar observations were seen in febrile non typhoidal cases except for one which had a titre of ≥1:320 for anti O and anti-H titres against serotype Typhi. In blood culture positive typhoid cases, 56 samples showed agglutinations of ≥1:80 for both anti O and anti-H titres against serotype Typhi. However two of the total sample tested showed no agglutinations. In all cases from three groups, anti-H titre for S. enterica serotype Paratyphi A and B were below 1:80. Conclusions: Widal test can be used as presumptive diagnostic tool in all the suspected cases of enteric fever if the titres are specifically raised.Keywords: enteric fever; titre; widal aggultination test. 

scholarly journals Pattern of Antibiotic Sensitivity in Enteric Fever: A Tertiary Care Hospital Experience

2014 ◽  
Vol 15 (2) ◽  
pp. 122-124 ◽  
Author(s):  
Samira Rahat Afroze ◽  
Muhammad Abdur Rahim ◽  
Md. Mehedi Hasan ◽  
Farhana Afroz ◽  
Hasna Fahmima Haque ◽  
...  
Keyword(s):  
Blood Culture ◽  
Nalidixic Acid ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Antibiotic Sensitivity ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Drug Resistant Strains

Objectives: To describe the antibiotic sensitivity pattern ofSalmonella typhi and Salmonella paratyphi from blood culture specimens. Methods: This cross-sectional study was done in the Department of Medicine, BIRDEM from July 2009 to June 2012. Standard laboratory and microbiological procedures were followed for blood culture and antibiotic sensitivity tests. Results: Among the 97 blood culture positive samples, S. typhi was 71 (73.2%) and S. paratyphi was 26 (26.8%). Multi-drug resistant strains of S. typhi and S. paratyphi were 23 (32.4%) and 3 (11.5%) cases respectively. Azithromycin, nalidixic acid, ciprofloxacin, levofloxacin and amoxicillin resistance was also found in a good number of cases (S. typhi and S. paratyphi: 71.8% and 57.7%, 42.3% and 30.8%, 38% and 34.6%, 38% and 26.9% and 38% and 26.9% cases respectively). Nineteen (31.1%) of the 61ciprofloxacin sensitive organisms were resistant to nalidixic acid. Ceftriaxone was sensitive in 100% of S. typhi and S. paratyphi. Cefixim, ciprofloxacin, levofloxacin, imipenem were among the most common sensitive antibiotics (S. typhi and S. paratyphi: 83.1% and 73.1%, 62% and 65.4%, 53.5% and 65.4%, 76.1% and 65.4% cases respectively). Conclusion: Ceftriaxone was the most sensitive antibiotic for treating enteric fever followed by cefixim, imipenem and ciprofloxacin. However, in suspected cases of enteric fever, blood culture should be requested before prescribing antibiotic.DOI: http://dx.doi.org/10.3329/jom.v15i2.20684 J MEDICINE 2014; 15 : 122-124

scholarly journals Antimicrobial sensitivity pattern of Salmonella typhi isolated from blood culture in a referral hospital

2011 ◽  
Vol 5 (1) ◽  
pp. 16-20 ◽  
Author(s):  
Bulbul Hasan ◽  
Sabera Gul Nahar ◽  
Laila Akter ◽  
Ahmed Abu Saleh
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Antimicrobial Susceptibility ◽  
Salmonella Typhi ◽  
Susceptibility Pattern ◽  
Widal Test ◽  
College Hospital ◽  
Medical College ◽  
Antimicrobial Susceptibility Pattern ◽  
Sensitivity Pattern

The present study has been carried out in an attempt to evaluate antimicrobial susceptibility patterns with special reference to susceptibility of Salmonella Typhi to ciprofloxacin isolated from blood culture. The study is also designed to find out the MIC of Ciprofloxacin by E- test. Blood samples were taken for culture sensitivity, Widal test and ICT from 100 clinically suspected cases of typhoid fever in 1st week of illness who attended at out patient department of Rajshahi Medical College Hospital (RMCH).The study was done in Microbiology Department of Rajshahi Medical College and Shishu Hospital, Dhaka. Diagnosis of patients was based on history of fever, blood culture, Widal test and ICT. The antimicrobial susceptibility pattern of isolates from blood culture was recorded. Further more, the minimum inhibitory concentration of Ciprofloxacin was determined by E-test for the isolates resistance to Ciprofloxacin. Out of 100 suspected cases of typhoid fever, blood culture positive for S. Typhi were 16 (16%). Antimicrobial susceptibility pattern of 16 isolates of S. Typhi showed that no isolate was resistant to Ceftriaxone and Ceftazidime, only 03(18.75%) were resistant to Ciprofloxacin and Azithromycin whereas 10(62.5%) were MDR showing resistance to Ampicillin, Co-trimoxazole and Chloramphenicol which are first-line antityphoidal drugs. On the other hand, all (100%) the isolates were resistant to Nalidixic acid. The study revealed that Ceftriaxone and Ceftazidime are the most effective drugs in the treatment of typhoid fever. Moreover, E-test has been found to be helpful to determine appropriate therapeutic dose of Ciprofloxacin especially in case of drug resistance and pediatric population.DOI: http://dx.doi.org/10.3329/bjmm.v5i1.15816 Bangladesh J Med Microbiol 2011; 05 (01): 16-20

scholarly journals Clinical Profile and Sensitivity Pattern of Salmonella Serotypes in Children: A Hospital Based Study

2011 ◽  
Vol 31 (3) ◽  
pp. 180-183 ◽  
Author(s):  
BG Joshi ◽  
K Keyal ◽  
R Pandey ◽  
BM Shrestha
Keyword(s):  
Salmonella Enterica ◽  
Enteric Fever ◽  
Wide Spectrum ◽  
Clinical Profile ◽  
Age Group ◽  
Cross Sectional ◽  
Female Ratio ◽  
Sensitivity Pattern ◽  
Study Results ◽  
Culture Positive

Introduction: Enteric fever is a systemic infection caused by the bacteria, Salmonella enterica serovar Typhi (S.typhi) and Salmonella enterica serovara Paratyphi (S. paratyphi A, B and C). Most of the burden of the disease is limited to the developing world and the disease still has the issues like wide spectrum of clinical presentation and multidrug resistance. Objectives: This study was done to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive enteric fever. Methods: A prospective cross-sectional study was conducted in Civil Service Hospital from February 2010 to January 2011 in the paediatric population in the age group of 2 to 14 years. Children with Salmonella species isolated in blood culture were included in the study. Results: Out of the 40 children with culture positive enteric fever, male to female ratio was 1.3:1 with common age group between 11-14 years. S typhi was isolated in 25 cases while S. paratyphi in 15 cases. Clinical features of S. typhi and S. paratyphi were indistinguishable. Both S.typhi and S. paratyphi were found to be 100% sensitive to drugs like Ceftriaxone, Cefotaxime, Cefixime and Chloramphenicol. Sensitivity to Ofloxacin was 100% in S. paratyphi and 92% in S.typhi. Similarly sensitivity of Azithromycin was 92% and 93% for S.typhi and S. paratyphi respectively. Conclusion: Salmonella serotype is still 100 % sensitive to third generation cephalosporin. Some percentage of resistance is seen with Ofloxacin in S. typhi and with Azithromycin in both S.typhi and S. paratyphi. Key words: Enteric fever; S.typhi; S.paratyphi; Sensitivity DOI: http://dx.doi.org/10.3126/jnps.v31i3.4382 J Nep Paedtr Soc 2011;31(3): 180-183

scholarly journals Study on the efficacy of ceftriaxone versus azithromycin for the treatment of uncomplicated enteric fever among the patients admitted in a tertiary level hospital

2021 ◽  
Vol 11 (1) ◽  
pp. 1
Author(s):  
Sougata Mitra ◽  
Masuma Khanam ◽  
M. Iqbal Hossain ◽  
Rukhsana Quadir
Keyword(s):  
Blood Culture ◽  
Physical Examination ◽  
Typhoid Fever ◽  
Clinical Cure ◽  
Enteric Fever ◽  
Salmonella Typhi ◽  
Clearance Time ◽  
Medical College ◽  
Fever Clearance Time ◽  
Culture Positive

Background: Typhoid fever is a severe debilitating and potentially life threating illness. In Bangladesh, typhoid fever is a round the year problem which sometimes take epidemic proportions. The reasons behind such occurrences are unsafe water supply, defective sewage system and unhygienic food handling practice. This study aimed to compare the efficacy of ceftriaxone and azithromycin in the treatment of uncomplicated enteric fever.Methods: An observational study was conducted at the department of pharmacology in Dhaka medical college, Dhaka, Bangladesh. Data were collected from blood culture positive patients for Salmonella typhi and Salmonella paratyphi, who admitted in the Dhaka medical college and hospital, Dhaka during the period of July 2015 to June 2016. Data was collected by using a structured questioner, face to face interview, physical examination and investigation reports. Patients were hospitalized during the entire treatment period and at admission evaluation was made by history and physical examination in a structured format. Subjects ware asked regarding changes in symptoms and possible adverse effects of the study drugs. All patients were asked to return two weeks after completion of treatment for follow up. Blood culture of Salmonella typhi or Salmonella paratyphi were done in all cases. Total 91 patients were culture positive for either S. typhi or S. paratyphi which were finally studied.Results: During the study period out of 91 patients, 51 were receiving ceftriaxone and 40 were receiving azithromycin. Clinical cure was achieved in 46 patients (90%) of ceftriaxone group and in 31 patients (78%) in the azithromycin group. There were no significant differences of clinical cure between both treatment groups (p>0.05). Mean fever clearance time in ceftriaxone group was 3±1.4 days and was 4±1.6 days for azithromycin group. Difference in fever clearance time was statistically significant (p<0.05). No clinical relapses were detected in any study subject. No major side effects of both drugs occurred in any subject.Conclusions: These results indicated that both ceftriaxone and azithromycin were effective against enteric fever caused by sensitive organisms and multi drug resistant S. typhi and S. paratyphi. It is concluded that ceftriaxone is more effective and can be a convenient alternative for the treatment of enteric fever, especially in developing countries like us where medical resources are scarce.

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