Typhoid is usually treatable with antibiotics, but resistance to the drugs is increasing, leading to more severe cases and hospitalizations. Pakistan has one of the highest rates of drug-resistant typhoid- more than 15,000 cases officially recorded – with contaminated water and poor sanitation contributing to the spread of the disease.
Overuse of antibiotics is a significant factor in the rise of drug-resistant bacteria, with global consumption increasing by nearly 50% between 2000 and 2018, particularly in South Asian countries like Pakistan.
Rapid diagnostic tests, like Typhidot and Widal, often result in false positives, causing unnecessary antibiotic prescriptions and contributing to resistance. Despite a ban on these rapid tests, they remain widely used in Pakistan, further driving the spread of drug-resistant typhoid.
Azithromycin, one of the few remaining effective antibiotics against XDR-typhoid, is starting to lose its effectiveness as doctors observe emerging strains that no longer respond to it.
“XDR-typhoid is the final warning sign. After this we will enter a stage where the superbug won’t respond to any drugs at all. That means we will go back to when typhoid was a more deadly disease. And that really worries us,” says Jehan Zeb Khan, a clinical pharmacist at Hayatabad Medical Complex in Peshawar.