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Reported levels of antibiotic resistance in Salmonella Typhi from South Sulawesi, Indonesia were very low (&lt; 1%) before 2001 and chloramphenicol remained the treatment of choice. Since 2001 however resistance has been rising and in 2007 6.8% of isolates were resistant to all three first line drugs: Ampicillin, chloramphenicol and co-trimoxazole. Ciprofloxacin resistance is currently at 3.90 %. At the same time there has been an increase in the number of reported cases. This may be because of improved diagnostics or it may be a genuine outbreak of drug resistant S. Typhi. In conclusion drug resistant typhoid fever will become a serious problem in Indonesia in the future, requiring the use of expensive drugs for the treatment of typhoid. A concerted effort is needed by the medical services to implement reliable diagnosis so that treatment or vaccination can be used to control the spread of drug resistant typhoid fever.

Enteric fever in endemic areas of Indonesia: an increasing problem of resistance