REVIEW: INTRODUCTION OF TYPHOID EXTENSIVELY DRUG-RESISTANT (XDR)
Salmonella typhi is a major infection problem in Pakistan. This disease affects middle-income countries but antimicrobial resistance and international travel. Decades of indiscriminate antibiotic use have to the evolution of multidrug-resistant strains (MDR) and more ultimately, extensively drug-resistant (XDR). The outbreak of XDR typhoid fever cases from 2016 to 2018 in the province of Sindh, WHO records that there are 5274 cases of XDR typhoid out of a total of 8,188 cases of typhoid fever reported in Pakistan. Since 12 September 2020, XDR typhoid 2883 cases reported in Pakistan. MDR strains are antibiotic first-generation antibiotic drugs such as chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole and second-generation drugs, such as fluoroquinolones, part of Asia and Africa. In Pakistan, all recommended antibiotics for typhoid fever and extensive drug-resistant (XDR) S. Typhi strain, include the first-generation, second-generation drugs, and third-generation cephalosporins, Meropenem or Azithromycin, and tigecycline. This review paper tries to increase the issue of XDR typhoid concerning its epidemiology, prevention, management, and Vision of the future and stresses a better understanding of antimicrobial stewardship and general surveillance of the disease.
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