الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
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Abstract
Typhoid fever is a highly communicable disease, affecting children and adults leading to bacteremia and inflammatory destruction of the intestine and other organs. Since 1990, a multi-drug resistant (M D R) variety of typhoid fever caused by S. typhi was responsible for numerous enterica outbreaks in India. IN Egypt, M D R strains were found responsible for an outbreak in Gharbeya Governorate in 1990. Recently some reports from India, south East Asia, Tajikistan and other countries in Europe documented some strains of S. typhi resistant to floroquinolones. The present study was designed in order to : 1- Determine the efficacy of various commonly used antibiotics in the treatment of enteric fever cases. 2- Study the ecological and clinical profile of patients showing antibiotics resistance. 3- Investigate the in vitro activities of new antibiotics against the Salmonella strains isolated from enteric fever cases. For these purpose 200 patients; proved to have recent attack of enterica using Widal test as well as blood culture & sensitivity tests were recruited from Alexandria Fever Hospital. All patients involved in the study were subjected to the following: I. Filling a predesigned questionnaire including: 1st. Personal and demographic data & Socioeconomic data. II. Thorough history taking about,Onset, clinical symptoms & signs, course of the illness, Previous similar conditions, investigations &Previous history of operation (cholycystectomy) and hospitalization also Vaccination or travel to endemic areas. 1st. Family history of similar cases. 2nd. Drugs prescribed, Associated diseases ( e.g. diabetes mellitus …etc) III. Complete medical (general and systemic) examination. IV. Stool analysis to detect parasitic infections among patients of the study especially schistosomiasis . V. Hematological analysis comprising: Complete blood picture &Tube agglutination Widal test on admission and 7 days later VI. Bacteriological investigations including, blood culture on admission for isolation and identification of Salmonella organism &Antibiotic susceptibility test to detect in vitro sensitivity of the isolated organism using same antibiotics prescribed ( chloramphenicol , co-trimoxazol , ampicillin , cefotaxim and ciprofloxacin ) . VII. All Patients included in the study were treated by the conventional drugs (chloramphenicol, ampicillin and/or co-trimoxazol or new antibiotics ( cefotaxim or ciprofloxacin ) for one week . After that all the patients were reexamined to assess the efficacy of treatment. The following doses were used : i-Chloramphenicol and ampicillin 50 mg /kg of body weight/ 4 hours ii-Co-trimoxazol 10 mg of trimethoprim + 50 mg of sulphamthoxazole /kg body weight /day (in 2 divided dose). iii- Cefotaxim 20 mg/kg body weight /day in 2 divided dose parentally. iv- Ciprofloxacin 500 mg twice daily for patients above 18 years of age. Data collected were , coded , tabulated and analyzed using different statistical tests including X2 , Odds ratio , ANOVA as well as multiple logistic regression analysis.