Lizhu Guo, Xin Du, Huanqi Wu, Shijun Xia, Jing Du, Xiangrong Kong, Xiaohui Yang, Chi Wang, Jianzeng Dong, Changsheng Ma, Lilly Engineer
Factors associated with patients' healthcare-seeking behavior and related clinical outcomes under China's hierarchical healthcare delivery system
Frontiers in public health
background typhoid fever presents significant challenge developing nations exacerbated emergence antibioticresistant strains due widespread prevalence overuse antibiotics study seeks assess antibiogram profiles salmonella species isolated blood cultures patients hospitalized two prominent tertiary care hospitals peshawar pakistan khyber teaching hospital kth hayatabad medical complex hmc examining profiles research aims provide valuable insights evolving landscape antibiotic resistance context typhoid fever management materials methods retrospective crosssectional study utilized data gathered two hospitals peshawar kth hmc cases enteric fever identified based positive blood cultures salmonella species study encompasses demographic information seasonal prevalence antibiogram profiles 3137 cases presented 2017 2023 results among total 3137 cases males accounted majority comprising 63 2044 cases particularly notable clustering cases among children adolescents aged one 24 years incidence peaked months summer spring april september terms salmonella typhi isolates considerable resistance noted firstline antibiotics amoxicillinclavulanate 801 cotrimoxazoletrimethoprimsulfamethoxazole 666 chloramphenicol 869 well ceftriaxone 797 ciprofloxacin 516 conversely certain antibiotics displayed higher sensitivity patterns including meropenem 978 doripenem 995 imipenem 977 ertapenem 965 polymyxin b 994 colistin 981 tigecycline 973 despite limited sample size 214 specimens fosfomycin demonstrated remarkable sensitivity 934 sensitivities amikacin gentamicin 907 815 respectively however sensitivity azithromycin concerning standing 665 antibiogram pattern salmonella exhibited significant drastic changes conclusion conclusion study sheds light higher prevalence typhoid fever among males notable seasonal peak observed summer spring months age group affected spans one 24 years salmonella isolates displayed significant resistance conventional firstline antibiotics alongside ciprofloxacin thirdgeneration cephalosporins azithromycin exhibited lower sensitivity compared amikacin gentamicin fosfomycin research advocates empirical use amikacin gentamicin fosfomycin meropenem treatment typhoid fever pakistan urgent measures including regular salmonella antibiogram surveillance antibiotic stewardship public health education salmonella vaccination programs deemed crucial primary disease prevention