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J Med Microbiol 56 (2007), 1490-1494; DOI: 10.1099/jmm.0.47353-0
© 2007 Society for General Microbiology
ISSN 1473-5644

In vitro activity of azithromycin, newer quinolones and cephalosporins in ciprofloxacin-resistant Salmonella causing enteric fever

Malini R. Capoor1, Deepti Rawat1, Deepthi Nair1, Azra S. Hasan1, Monorama Deb1, Pushpa Aggarwal1 and Parukutty Pillai2

1 Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India

2 Department of Microbiology, Majeedia Hospital, Hamdard University, New Delhi, India

Correspondence
Deepthi Nair
deepthinair2{at}gmail.com

Received 18 April 2007
Accepted 6 July 2007

The therapeutic alternatives available for use against ciprofloxacin-resistant enteric fever isolates in an endemic area are limited. The antibiotics currently available are the quinolones, third-generation cephalosporins and conventional first-line drugs. In this study, the MICs of various newer drugs were determined for 31 ciprofloxacin-resistant enteric fever isolates (26 Salmonella enterica serovar Typhi and 5 S. enterica serovar Paratyphi A). MICs for ciprofloxacin, ofloxacin, gatifloxacin, levofloxacin, cefotaxime, cefixime, cefepime and azithromycin were determined using Etest strips and the agar dilution method. By Etest, all of the ciprofloxacin-resistant isolates had ciprofloxacin MICs ≥32 µg ml–1. S. Typhi showed MIC90 values of 0.50, 0.25 and 0.38 µg ml–1 for cefixime, cefotaxime and cefepime, respectively. For the cephalosporins, a negligible difference in MIC90 and MIC50 values for S. Typhi and S. Paratyphi A was observed. A single isolate of S. Typhi showed a high azithromycin MIC of 64 µg ml–1. The MIC90 value for azithromycin in S. Typhi and S. Paratyphi was 24 µg ml–1. Gatifloxacin demonstrated lower resistance (80.8 %) compared with the other quinolones (92–100 %) in S. Typhi. The rise in MIC levels of these antimicrobials is a matter for serious concern.




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