Antibiotic Resistance Patterns in Pediatric Typhoid Cases in Combined Military Hospital Peshawar

Background and Aim: Poor public health infrastructure and low socioeconomic indicators are the primary contributors to the prevalence of typhoid fever. Currently, Pakistan is facing the challenges of severe outbreak of typhoid fever, resulting in increased rates of illness and fatalities, particularly among the pediatric population. The aim of the current study was to investigate the antibiotic resistant patterns in pediatric typhoid cases. Patients and Methods: A cross-sectional study investigated 173 typhoid cases at the Department of Pediatrics, Combined Military Hospital, Peshawar from July 2024 to February 2025. Children aged 1 day to 12 years of either gender with prior history of fever and positively diagnosed typhoid fever were enrolled. A self-structured questionnaire designed for data collection such as age, gender, socioeconomic status, and drinking water status. Symptoms of typhoid fever were recorded. Blood sample taken from each children and tested for antibiotic susceptibility. Data analysis was done using SPSS version 26. Results: Out of 173 typhoid cases, there were 106 (61.3%) male and 67 (38.7%) female children. Salmonella typhi was identified in 156 (90.2%) of the patients, while Salmonella paratyphi was found in 17 (8.8%) of the cases. Significant determinants for the acquisition of salmonella infection included youth (68.2%), male sex (61.3%), middle to low socioeconomic status (80.9%), and the intake of untreated water (78%). Moreover, a notable prevalence of extended drug resistance found in 70.5% of the affected individuals. The majority of the isolates demonstrated sensitivity to meropenem and azithromycin, with rates of 95.8% and 94.3%, respectively. Resistance to ceftriaxone was widespread affecting various age groups: 1 day-3 years (96%), 4-7 years (90%), and 8-12 years (100%), with a notable predominance in males (57%). Conclusion: The probability of extended drug-resistant typhoid fever increased among children aged 1 day to 3 years, males, and individuals from lower socioeconomic backgrounds. Consumption of untreated water recognized as a significant factor contributing to this issue. It is essential to implement measures across all healthcare levels to ensure the responsible use of antibiotics.