A critical analysis of the management of typhoid fever in a tertiary care hospital in india

Enteric fever is endemic in many parts of the third world. In India, it is the fifth most common infectious disease. With increasing resistance to fluoroquinolones and re-emergence of chloramphenicol, the policy of empirical treatment of typhoid fever (TF) needs to be rationalized. This study was carried out to compare the prescription pattern of typhoid fever for two successive years, to study the change in trend in the prescription pattern, to rationalize prescription and to check the rationality of the use of drugs. A retro-spective analysis of the management of all the cases of TF during the year 2002 & 2003 was carried out at Kasturba hospital, Manipal. Prescriptions of all the case records of in - patients diagnosed as TF were collected through a specifically designed proforma and analysed. A total number of 96 cases were admitted in 2002 and 90 in 2003. Ceftriaxone emerged as the most commonly used antibiotic in both the years. Fever was seen in almost all the cases. Number of cases with widal tested as positive were 33 in 2002 and 42 in 2003. Number of cases resistant to cephalosporins were nil in both the years. Cephalosporins continue to be used commonly .Use of ciprofloxacin has declined. Widal test continues to be carried out commonly though it is of little practical value and easily misinterpreted. Re-emergence of chloramphenicol is a welcome sign.