Clinical, serological, microbiological, and outcome study of 200 cases of short duration fever without prior exposure to antibiotic

Abstract

Background : Short duration fever is a very common presenting symptom of infections which are mostly self-limiting and do not require any antibiotics. Most of these patients presenting to primary care centers are exhibited antibiotics irrationally without any investigation results. Antibiotics are not a panacea for all fevers. This title was chosen to discourage the usual practice of indiscriminate use of antibiotics in short duration self-limiting fevers, increasing emergence of antibiotic resistance bacteria. This study was conceived and designed after The Lancet in 2010 reported the emergence of resistant New Delhi strain of metallo-beta-lactamase 1 Gram-negative Enterobacteriaceae from India, Pakistan, and the UK due to irrational use of antibiotics. Moreover, there are very scanty literature reports on Short duration Fevers. This study is likely to advocate rational scientific approach to the management of short duration fever. Objectives: This study was conducted to (a) arrive at a definite diagnosis and formulate various etiologies of short duration fever in this tertiary care hospital, (b) rational use of specific antibodies when indicated, and (c) study the outcome of therapy. Materials and Methods: This was an observational cross-sectional study comprising 200 fresh consecutive inpatients of fever of <2 weeks duration who has not been exposed to any antibiotic prior to hospitalization between July 2012 and September 2014. They were subjected to clinical, microbiological, and serological studies and other specific studies when indicated. Results: Common etiology for fever was found to be nonspecific viral fever (45%), which did not need antibiotics, then dengue fever (26.5%), enteric fever (7%), and malaria with Plasmodium vivax (4%) predominance. Conclusion: Clinicians needs to restrict to indiscriminate use of antibiotics in any febrile patients to prevent the emergence of antibiotic resistance. More number of similar studies need to be carried out globally to create awareness among clinician regarding the cautious and rational use of antibiotic therapy in short febrile patients.