Expert Opinion on the Clinical use of Antibiotics for the Management of Infections and Enteric Fever in Indian Settings

Abstract

Objective: The present survey-based study aims to gather clinicians’ perspectives regarding the antibiotic prescription pattern for the management of infections and enteric fever in Indian settings. Methodology: The current multiple-response questionnaire-based survey consisted of 17 questions pertaining to clinical observations, clinical experience, and antibiotic prescription practice of specialists involved in the management of infections and enteric fever. Result: Out of 246 participants, 89% recommended cefixime as the preferred monotherapy drug for enteric fever. The recommended combination therapies for enteric fever were cefixime and ofloxacin, cefixime and azithromycin, and cefpodoxime and ofloxacin, as indicated by 38%, 32%, and 25% of clinicians, respectively. Approximately 61% of the clinicians reported frequently prescribing cefixime for urinary tract infections (UTI). According to 68% of the clinicians, the recommended cefixime dose for treating typhoid fever is 15-20 mg/kg. More than half (55%) of the clinicians recommended amoxicillin/clavulanic acid for the treatment of respiratory infections. Majority (78%) of the clinicians chose cefixime as an effective option for managing recurring infections. A considerable proportion (76%) of clinicians reported no side effects following antibiotic therapy. Conclusion: The study provides valuable insights into the use of antibiotics in infection and enteric fever in Indian settings. Cefixime therapy is recommended by clinicians in the treatment of enteric fever, UTI, and recurring infections. The preferred treatment option for enteric fever includes a combination of cefixime with either ofloxacin or azithromycin. The recommended cefixime dose for typhoid fever is in the range of 15-20 mg/kg. Respiratory infections are typically treated with amoxicillin/clavulanic acid.