Clinical Response of Meropenem versus Meropenem and Azithromycin in Extensively Drug-Resistant Salmonella

Muhammad Ameen; Sundus Ali; Jawad Ashraf; Naaz Ikram; Ayesha  Siddiqi; Asif Naseer

doi:10.51253/pafmj.v74i6.12041

Authors

Muhammad Ameen Department of Medicine, Armed Forces Institute of Cardiology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Sundus Ali Department of Medicine, Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
Jawad Ashraf Department of Medicine, Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
Naaz Ikram Department of Medicine, Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
Ayesha Siddiqi Department of Pathology, Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan
Asif Naseer Department of Medicine, Combined Military Hospital Malir/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i6.12041

Keywords:

Azithromycin, Drug Therapy, Extensive Drug Resistance, Meropenem, Salmonella Typhi.

Abstract

Objectives: To compare the clinical response of Meropenem versus a combination of Meropenem and Azithromycin in Extensively Drug-Resistant Salmonella.

Study Design: Quasi-experimental study.

Place and Duration of Study: Tertiary Care Hospital, Malir Pakistan, from Mar to Sep 2023.

Methodology: A total of 100 patients (50 in the Meropenem group and 50 in the Meropenem and Azithromycin group) who were diagnosed with typhoid fever secondary to extensively drug-resistant salmonella were included. The duration of hospital stay, post-therapy C-reactive protein, time for defervescence, and complete clinical response were compared between the groups.

Results: Median age was 29(49–16) years. There were 78(78%) males and 22(22%) females. Median weight of patients was 75(90–55) kg. Median duration of fever was 6(14–1) days. Median baseline C-reactive protein was 44(167–13) mg/dl. Complete clinical response in Meropenem alone group 49(98%) was significantly higher as compared to Meropenem + Azithromycin group 38(76%), (p=0.001). Similarly, duration of hospital stay and time to defervescence were also significantly shorter in the Meropenem alone group (p<0.001).

Conclusion: Meropenem alone is better than the combination of Meropenem + Azithromycin, with a shorter hospital stay, lesser time to defervescence, and better clinical response.

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