Open AccessQuinolone and cephalosporin resistance in enteric fever
Author(s) -
Malini R. Capoor,
Deepthi Nair
Publication year - 2010
Publication title -
journal of global infectious diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.437
H-Index - 25
eISSN - 0974-8245
pISSN - 0974-777X
DOI - 10.4103/0974-777x.68529
Subject(s) - ciprofloxacin , nalidixic acid , tigecycline , cephalosporin , azithromycin , mecillinam , drug resistance , antimicrobial , antibiotic resistance , antibiotics , microbiology and biotechnology , ampicillin , medicine , population , biology , enterobacteriaceae , environmental health , escherichia coli , gene , biochemistry
Enteric fever is a major public health problem in developing countries. Ciprofloxacin resistance has now become a norm in the Indian subcontinent. Novel molecular substitutions may become frequent in future owing to selective pressures exerted by the irrational use of ciprofloxacin in human and veterinary therapeutics, in a population endemic with nalidixic acid-resistant strains. The therapeutics of ciprofloxacin-resistant enteric fever narrows down to third- and fourth-generation cephalosporins, azithromycin, tigecycline and penems. The first-line antimicrobials ampicillin, chloramphenicol and co-trimoxazole need to be rolled back. Antimicrobial surveillance coupled with molecular analysis of fluoroquinolone resistance is warranted for reconfirming novel and established molecular patterns for therapeutic reappraisal and for novel-drug targets. This review explores the antimicrobial resistance and its molecular mechanisms, as well as novel drugs in the therapy of enteric fever.