Empirical antibiotics therapy used for typhoid fever in pediatrics presenting in a tertiary care hospital.

Abstract

Objective: To determine the frequency and efficacy of empirical antibiotic therapy used for treatment of pediatric typhoid fever in a tertiary care hospital. Study Design: Cross-sectional study. Setting: Department of Pediatric Medicine, Fatima Memorial Hospital Lahore. Period: 12 September 2025 to 12 March 2026. Methods: A total of 140 children aged 1-15 years, diagnosed with typhoid fever confirmed by blood culture, were included. Data on demographics, clinical features, and empirical antibiotic prescriptions were collected. Antibiotic sensitivity was assessed for the prescribed empirical antibiotics. Results: The study included 140 children with a mean age of 8.0 years; 51.4% were male. The most commonly prescribed empirical antibiotic was ceftriaxone (52.9%), followed by cefixime and ciprofloxacin (19.3%). Imipenem and azithromycin were prescribed to 4.3% of patients. Sensitivity rates were 70% for ciprofloxacin, 28% for ceftriaxone, 62% for cefixime, 50% for azithromycin, and 100% for imipenem. Only 43% of patients were sensitive to the empiric antibiotic prescribed. Conclusion: The study highlights dependence on ceftriaxone in the treatment of treating pediatric typhoid fever, despite moderate sensitivity rates. The findings demonstrate that there is a need for antibiotic stewardship program that guide appropriate empirical therapy and can also counter the increase of antibiotic resistance in pediatric populations.