Concerning Trend in Ceftriaxone Minimum Inhibitory Concentration (MIC): Implications for the Treatment of Enteric Fever

Abstract

Introduction:Salmonella typhi and paratyphi - related enteric fever still poses serious health risks to people all over the world. Ceftriaxone and azithromycin were recommended as the preferred treatments for enteric fever following the emergence of fluoroquinolone resistance. Several reports of ceftriaxone resistance have also been reported, hence accurate medication susceptibility tracking is essential to maintain the empiric management of enteric fever. This study’s objective is to determine the MIC of ceftriaxone in order to help clinicians prescribe the right dosage and stop the emergence of resistance. Material and Methods: The investigation was carried out in 800 bedded hospital in Ghaziabad using a cross-sectional prospective design. A total of 228 Salmonella isolates were included in this investigation. The isolates’ antibiotic susceptibility was assessed using the Kirby Bauer disc diffusion method, and the ceftriaxone MIC was calculated using the Broth Micro-Dilution (BMD) method. Result: Of the 228 Salmonella species that were isolated, 64 (28.07%) were Salmonella paratyphi A, and 164 (71.92%) were Salmonellatyphi. Ceftriaxone resistance was found in 33 (20.12%) Salmonellatyphi strains while it was found in 14 (21.87%) S. paratyphi A strains. 0.125 μg/ml was the ceftriaxone MIC50 value for S. typhi as well as for paratyphi A but the MIC90 value was 8 μg/ml in S. typhi and 4 μg/ml in S. paratyphi A isolates. Conclusion: This investigation revealed a concerning rise in the MIC to ceftriaxone and the reemergence of sensitivity to first-line medications.