Multidrug-resistant typhoid: What we need to know
Typhoid fever, caused by the Salmonella typhi bacteria, remains a public health concern in many parts of the world, particularly in South Asia. While antibiotics once made typhoid easily treatable, a growing number of cases no longer respond to the commonly used antibiotics. Some cases are also resistant to the latest antibiotics. This rise of multidrug resistance threatens to make typhoid harder to control.[1]
What is multidrug-resistant typhoid?
Multidrug-resistance (MDR) occurs when Salmonella typhi becomes resistant to several antibiotics that once treated the infection. In some parts of South Asia, extensively drug-resistant (XDR) strains have also appeared, which resist almost all available antibiotics, leaving very limited treatment options.[2]
The rise of these resistant strains means that standard antibiotics often fail, leading to a greater risk of complications or relapse.
How does typhoid become drug-resistant?
Drug resistance develops naturally over time, but it spreads faster because of how antibiotics are used and misused. When people take antibiotics without a prescription or stop their medicines early because of improved symptoms, microbes are exposed to lower concentration of the drugs, without being fully killed. The strongest bacteria survive and adapt, passing on their resistance to others. Over time, this leads to antimicrobial resistance (AMR), a situation where bacteria, viruses, fungi and parasites no longer respond to medicines designed to kill them.[1,4]
What are MDR and AMR?
- MDR (Multidrug Resistance): When a bacterium becomes resistant to multiple antibiotics that are normally used to treat it.[6]
- AMR (Antimicrobial Resistance): A broader term that refers to resistance among all microbes (bacteria, viruses, fungi and parasites) against the drugs meant to control them.[1]
MDR is one type of AMR, and both make infections harder to treat, increasing the risk of spread to others.
Differences between MDR and XDR
| Type | Meaning |
|---|---|
| Multidrug-resistant (MDR) | Resistant to at least one of three commonly used antibiotics[4] |
| Extensively drug-resistant (XDR) | Defined as MDR plus resistance to almost all commonly used antibiotics[4] |
In Pakistan, extensively drug-resistant (XDR) typhoid has become alarmingly common. India has also reported cases of resistant strains that no longer respond to key antibiotics. While full-scale XDR outbreaks haven’t been seen yet, treatment options are narrowing.[4]
How to prevent the rise of MDR?[1]
- Complete the full course of antibiotics as prescribed by your doctor, even if you start feeling better.
- Never self-medicate. Taking antibiotics without a doctor’s advice can do more harm than good.
- Avoid pestering doctors for antibiotics for common colds or viral fevers as they may fuel resistance.
- Do not reuse leftover antibiotics or share them with others.
MDR typhoid’s prevention and control begins with responsible antibiotic use. Each time antibiotics are misused, we give bacteria another chance to grow stronger. Once resistance develops, it spreads rapidly across communities and borders.
What can individuals do?
- Typhoid vaccination reduces your risk of infection and, in turn, the need for antibiotics.[5]
- Wash your hands thoroughly with soap, especially before eating or preparing food, to avoid typhoid.[3]
- Avoid raw or undercooked foods or foods prepared unhygienically.[7]
- Spread awareness about antibiotic misuse and antibiotic resistance in typhoid fever.
Conclusion
Multidrug-resistant Salmonella typhi is a growing threat that requires urgent attention. We can prevent it through proper antibiotic use, typhiod vaccines and following good hygiene. If you or your family haven’t yet received the typhoid vaccine, speak to your doctor today. By taking preventive steps, we can protect ourselves and help preserve the power of antibiotics for future generations.
FAQs
What causes multidrug-resistant typhoid?
MDR typhoid is caused by Salmonella typhi bacteria that have become resistant to commonly used antibiotics, mainly due to misuse or overuse of these drugs.
How is multidrug-resistant Salmonella Typhi treated?
Multidrug-resistant Salmonella typhi’s treatment often requires newer or stronger antibiotics, which are typically used under strict medical supervision. Don’t self-medicate, and follow your doctor’s prescription to stay healthy.
Can antibiotics still cure typhoid fever?
Yes, but because of the rise of AMR, not all antibiotics work anymore. Which is why medical guidance and laboratory testing are essential before treatment.
What are the best control measures for typhoid fever?
Vaccination, safe and hygenically prepared food and water practices and good sanitation are the best ways to prevent typhoid. Completing the full antibiotic course also helps prevent relapse and resistance.
Is the typhoid vaccine effective against resistant strains?
Yes. The vaccine prevents infection altogether, including by drug-resistant strains, by stopping Salmonella typhi from entering the body in the first place.
Resources
- https://www.who.int/news-room/fact-sheets/detail/antimicrobial-resistance
- https://pmc.ncbi.nlm.nih.gov/articles/PMC8703728/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9885025/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC9216270/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC6183139/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC11255812/
- https://www.cdc.gov/typhoid-fever/prevention/index.html
Disclaimer: A public awareness initiative by Bharat Biotech International Limited. This information is for general awareness only and does not constitute medical advice. The doctors, medical facilities and graphics shown are for illustrative purposes only. For any medical advice or any question or concern you may have regarding your condition, consult your doctor.