Comparison of Single vs Combination Drug Therapy in Extensively Drug Resistant Salmonella typhi: An Observational Study from Pakistan

Figures & data

Figure 1 Patient stratification.

Table 1 Clinical Characteristics and Outcome of Patients Admitted with XDR Typhoid

Variables	Total n=254	Combination Drug Therapy n=190	Single Drug Therapy n=64	p-value
Age
Age Mean ± SD	11.741 ± 10.565	11.61 ± 10.35	12.12 ± 10.06	0.735
≤ 5 years	77 (30%)	61 (32.1%)	16 (25%)	0.285
5–10 years	81 (31%)	58 (30.5%)	23 (35.9%)	0.422
≥10 - ≤18 years	28 (11%)	23 (12.1%)	5 (7%)	0.343
>18 years	68 (26.7%)	48 (25.2%)	20 (31.2%)	0.350
Gender
Male	179 (70.4%)	134 (70.5%)	45 (70.3%)	0.974
Female	75 (29%)	56 (29.4%)	19 (29.6%)
Symptoms at Presentation
High grade fever ≥101°F	216 (85%)	164 (86.3%)	52 (81.2%)	0.326
Fever Duration Mean ± SD	12.37±10.22	12.37±9.89	12.38±11.22	0.995
Chills	162 (63.7%)	118 (62.1%)	44 (68.7%)	0.339
Abdominal pain	97 (38.1%)	75 (39.4%)	22 (34.3%)	0.468
Vomiting	57 (22.4%)	50 (26.3%)	7 (10%)	0.023*
Loose motions	44 (17.3%)	38 (20%)	5 (7.81%)	0.02*
Defervescence
Yes	239 (94%)	184 (96.8%)	55 (85.9%)	0.001*
Defervescence of fever Mean ± SD	4.63 ± 2.9	5.03 ± 2.98	3.45 ± 2.48	0.000*
Defervescence within 1 week
Yes	222 (87%)	162 (85.2%)	60 (93.7%)	0.05
Outcome
Hospital stay Mean ± SD	6.01± 3.94	6.55±4.164	4.42±2.66	0.000*
Discharged	253 (99.6%)	189 (99.7%)	63 (98.4%)	0.084
Expired	1 (0.39%)	0	1 (1.56%)

Note: *Statistically significant.

Abbreviations: XDR, Extensively Drug Resistant, SD, Standard Deviation.

Table 2 Complication Occur in Patients with XDR Salmonella typhi

Complication	Total (n=108)	Combination Therapy (n=190)	Single Therapy (n=64)	P-value
Thrombocytopenia	63 (58.3%)	49	14	0.531
Pancytopenia	28 (25.9%)	26	2	0.02*
Lower GI bleed	15 (13.8%)	11 (5.78%)	4 (6.25%)	0.892
GI perforation	8 (7.4%)	7 (3.68%)	1 (1.56%)	0.401
Altered sensorium	6 (5.5%)	6 (3.15%)	0 ()	0.172

Note: *Statistically significant.

Abbreviations: XDR, Extensively Drug Resistant, GI, Gastro-Intestinal.

Table 3 Length of Hospital Stays in Patients with XDR Salmonella typhi

Variable	Mean	Combination Therapy	Single Therapy	P-value
Hospital stay	6.01± 3.94	6.55 ± 4.164	4.42 ± 2.66	0.000*
Fever duration	12.37 ± 10.22	12.37 ± 9.89	12.38 ± 11.22	0.995
Defervescence of fever	4.63 ± 2.9	5.03 ± 2.98	3.45 ± 2.48	0.000*

Note: *Statistically significant.

Abbreviation: XDR, Extensively Drug Resistant.

Figure 2 Single vs Dual combination therapy relationship to defervescence of fever days.

Figure 3 Defervescence time in relationship to administrated drugs.