According to the notice, SHCC had warned that a dangerous and resistant strain of Salmonella Typhi, that had emerged in Sindh in 2016, continues to infect the population. This strain of microorganisms has been termed 'Extreme Drug Resistant' or the XDR Typhoid strain.
The notice reiterates that Karachi and Hyderabad are two cities that are the most affected and cites with a high potential of spread.
Two antibiotics that are efficient against this strain are Azithromycin (oral) and Carbapenem (intravenous). These antibiotics are specific to certain microorganisms and can be very costly.
SHCC requests and advises all doctors to carefully prescribe the Azithromycin antibiotic specifically for Upper respiratory tract infections and other bacterial infections. Similarly, SHCC has also advised that Carbapenem be reserved for conditions such as sepsis and organisms sensitive to Carbapenem only.
In other complicated cases, doctors have been advised to refer the patient to an infectious diseases expert and medical consultants for further evaluation.