The emergence of antimicrobial resistant Salmonella typhi in Qatar: epidemiology and therapeutic implications

Multiresistant Salmonella seems to be a growing problem in Qatar and its treatment remains problematic. Of 100 Salmonella bacteraemias that occurred between 1 October 1989 and 30 September 1990, 30 were caused by S. typhi resistant to one or more of the conventional antibiotics usually recommended for the treatment of typhoid fever (ampicillin, chloramphenicol, and trimethoprim-sulphamethoxazole). Of those, 25 (83%) were acquired by patients during visits to the Indian subcontinent. Two patients with isolates sensitive to ampicillin were successfully treated with amoxicillin, 6 paediatric patients were cured with cefotaxime, and 20 adult patients responded favourable to ciprofloxacin. A 9 year old boy failed initial therapy with cefuroxime but responded well to ciprofloxacin. One adult patient was treated successfully with a combination of ciprofloxacin and cefotaxime. We conclude that cefotaxime and ciprofloxacin can serve as first line therapy for typhoid fever in areas where multi-resistant Salmonella is prevalent.