As a physician, I often worry when first-line treatments begin to fail — and that’s what’s happening in Pune: Salmonella typhi strains resistant to ceftriaxone have now been documented. Although azithromycin still works for these cases, this trend signals that our antibiotic arsenal is eroding. In practice, this means that empirical therapy for typhoid must be reconsidered, diagnostics (blood cultures, sensitivity testing) must be more routinely done, and treatment guidelines urgently updated. Without action, patient outcomes worsen: increased risk of complications, longer hospital stays, higher morbidity, mortality, and cost.

How can hospitals and labs improve access to reliable diagnostics for typhoid (blood culture, sensitivity) especially in outpatient settings?