The Influence of Reduced Susceptibility to Fluoroquinolones in Salmonella enterica Serovar Typhi on the Clinical Response to Ofloxacin Therapy
2011

How Salmonella Typhi Resistance Affects Treatment with Ofloxacin

Sample size: 540 publication 10 minutes Evidence: high

Author Information

Author(s): Christopher M. Parry, Ha Vinh, Chinh Nguyen Tran, John Wain, James I. Campbell, Tran Tinh Hien, Jeremy J. Farrar, Stephen Baker

Primary Institution: Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam

Hypothesis

What is the relationship between ofloxacin treatment response and the ofloxacin minimum inhibitory concentration (MIC) of Salmonella Typhi?

Conclusion

Higher levels of resistance to ofloxacin in Salmonella Typhi are associated with poorer treatment outcomes.

Supporting Evidence

  • 96% treatment success when the ofloxacin MIC was ≤0.125 µg/mL.
  • 73% treatment success when the MIC was between 0.25 and 0.50 µg/mL.
  • 53% treatment success when the MIC was 1.00 µg/mL.
  • Higher MICs correlate with longer fever clearance times.

Takeaway

If the bacteria causing typhoid fever are resistant to a medicine called ofloxacin, it might not work well, and patients could get sicker.

Methodology

Data from seven randomized controlled trials of enteric fever patients treated with ofloxacin was analyzed to determine the relationship between treatment response and the MIC of the infecting isolate.

Limitations

The study only includes infections with Salmonella Typhi and may not apply to other strains.

Participant Demographics

Patients with uncomplicated enteric fever from Vietnam.

Statistical Information

P-Value

<0.001

Confidence Interval

95% CI; 6.62–44.04

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pntd.0001163

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