Troubling news from Asia about treating enteric fever: a coming storm

Abstract

In The Lancet Infectious Diseases, Amit Arjyal and colleagues report the results from their randomised clinical trial comparing gatifl oxacin with ceftriaxone for patients with uncomplicated enteric fever in Nepal. Their two main fi ndings are sobering. First, they suggest that fl uoroquinolones should no longer be recommended as front-line empirical treatment for individuals with enteric fever in Nepal. Second, a large proportion of individuals in Nepal who are syndromically characterised as having uncomplicated enteric fever probably have an alternative diagnosis.