Trial reportAntimicrobial agents and chemotherapy2015
Clinically and microbiologically derived azithromycin susceptibility breakpoints for Salmonella enterica serovars Typhi and Paratyphi A.
Trial report in Antimicrobial agents and chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 39 papers.
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Who cites it
39 citing papers in PubMed, 65 citations in OpenAlex.
- Azithromycin in severe malaria bacterial co-infection in African children (TABS-PKPD): a phase II randomised controlled trial.BMC medicine · 2024Trial
- Treatment Response in Enteric Fever in an Era of Increasing Antimicrobial Resistance: An Individual Patient Data Analysis of 2092 Participants Enrolled into 4 Randomized, Controlled Trials in Nepal.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Trial
- Gatifloxacin versus ceftriaxone for uncomplicated enteric fever in Nepal: an open-label, two-centre, randomised controlled trial.The Lancet. Infectious diseases · 2016Trial
- Global trends and molecular epidemiology of Azithromycin-resistantOne health (Amsterdam, Netherlands) · 2026Article
- Azithromycin Resistance in Salmonella Typhi and Paratyphi Across South Asia: A Systematic Review and Meta-Analysis.Open forum infectious diseases · 2026Review
- Antimicrobial Resistance in Sub-Saharan Africa: A Comprehensive Landscape Review.The American journal of tropical medicine and hygiene · 2025Review
- Azithromycin resistance inJAC-antimicrobial resistance · 2025Article
- Nanomotion technology for testing azithromycin susceptibility ofMicrobiology spectrum · 2025Article
- A systematic review of recent outbreaks and the efficacy and safety of drugs approved for the treatment ofIJID regions · 2025Review
- Plasma concentration of azithromycin and correlation with clinical outcomes in patients with enteric fever.JAC-antimicrobial resistance · 2025Article
- Prevalence of azithromycin resistance after the COVID-19 era in clinical bacterial isolates from a tertiary care hospital in Gurugram, India.Frontiers in microbiology · 2025Article
- Increased susceptibility to azithromycin of Pseudomonas aeruginosa biofilms using RPMI 1640 testing media.APMIS : acta pathologica, microbiologica, et immunologica Scandinavica · 2024Article
- The intrinsic macrolide resistome ofAntimicrobial agents and chemotherapy · 2024Article
- Synthetic Glycans to Improve Current Glycoconjugate Vaccines and Fight Antimicrobial Resistance.Chemical reviews · 2022Review
- Antimicrobial susceptibility and genomic profiling ofIJID regions · 2022Article
- Making Antimicrobial Susceptibility Testing More Physiologically Relevant with Bicarbonate?Antimicrobial agents and chemotherapy · 2022Article
- Proximal Binding Pocket Arg717 Substitutions in Escherichia coli AcrB Cause Clinically Relevant Divergencies in Resistance Profiles.Antimicrobial agents and chemotherapy · 2022Article
- Virulence and antimicrobial resistance factors inFrontiers in veterinary science · 2022Article
- Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management.The Journal of infectious diseases · 2021Article
- Tebipenem as an oral alternative for the treatment of typhoid caused by XDR Salmonella Typhi.The Journal of antimicrobial chemotherapy · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
35 authors at 15 institutions in 9 countries.
Funding
Abstract
Azithromycin is an effective treatment for uncomplicated infections with Salmonella enterica serovar Typhi and serovar Paratyphi A (enteric fever), but there are no clinically validated MIC and disk zone size interpretative guidelines. We studied individual patient data from three randomized controlled trials (RCTs) of antimicrobial treatment in enteric fever in Vietnam, with azithromycin used in one treatment arm, to determine the relationship between azithromycin treatment response and the azithromycin MIC of the infecting isolate. We additionally compared the azithromycin MIC and the disk susceptibility zone sizes of 1,640 S. Typhi and S. Paratyphi A clinical isolates collected from seven Asian countries. In the RCTs, 214 patients who were treated with azithromycin at a dose of 10 to 20 mg/ml for 5 to 7 days were analyzed. Treatment was successful in 195 of 214 (91%) patients, with no significant difference in response (cure rate, fever clearance time) with MICs ranging from 4 to 16 μg/ml. The proportion of Asian enteric fever isolates with an MIC of ≤ 16 μg/ml was 1,452/1,460 (99.5%; 95% confidence interval [CI], 98.9 to 99.7) for S. Typhi and 207/240 (86.3%; 95% CI, 81.2 to 90.3) (P < 0.001) for S. Paratyphi A. A zone size of ≥ 13 mm to a 5-μg azithromycin disk identified S. Typhi isolates with an MIC of ≤ 16 μg/ml with a sensitivity of 99.7%. An azithromycin MIC of ≤ 16 μg/ml or disk inhibition zone size of ≥ 13 mm enabled the detection of susceptible S. Typhi isolates that respond to azithromycin treatment. Further work is needed to define the response to treatment in S. Typhi isolates with an azithromycin MIC of >16 μg/ml and to determine MIC and disk breakpoints for S. Paratyphi A.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.