Novel strategies to combat the antimicrobial resistance against Salmonella Typhi

Typhoid fever is a life-threatening health issue affecting millions of people worldwide. Successful management of typhoid fever requires multidisciplinary strategies, including sanitation and hygiene interventions coupled with therapeutic approaches. Typhoid fever is more prevalent in low and middle-income nations. With the rise of multidrug-resistant Salmonella Typhi isolates, high-dose therapy with adverse effects has become prominent. Existing vaccines are associated with certain limitations, such as reduced immunogenicity in different age groups, along with an improper framework for active immunization surveillance in endemic regions. Epidemiological data imply an increase in multi-drug and extensively drug-resistant S. Typhi isolates, requiring more effective typhoid fever treatments. This review showed the global burden of S. Typhi antibiotic resistance and typhoid fever treatment problems. The review comprehensively discussed the various novel drug and vaccine delivery strategies to counteract the antibiotic resistance against S. Typhi. The review also discusses novel therapeutic targeting of Peyer patches as a medication or vaccine delivery platform to overcome antibiotic treatment's disadvantages due to oral vaccine development issues. [Display omitted] •Typhoid fever is a systemic disease caused by Salmonella Typhi affecting low and middle-income countries of the world.•Advent of antibiotic resistance is a global issue in typhoid fever.•The condition became worse with the emergence of multidrug and extensively resistant S. Typhi isolates.•Novel vaccine delivery strategies are pivotal in combating antimicrobial resistance against Salmonella Typhi.•Oral nanoparticle-encapsulated vaccines enables targeted delivery to mucosal surfaces, resulting in robust immune responses.