Public health

Pathology

Archaeology

Government (linguistics)

Disease

Coronavirus disease 2019 (COVID-19)

Antibiotics

Infectious disease (medical specialty)

Biology

Microbiology

Pandemic

Nursing

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Virology

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Closet

Azithromycin

Sanitation

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Typhoid fever

Medicine

Environmental health

Public Health in Practice

Extensively drug resistant typhoid fever is a major public health concern in Pakistan. During the COVID-19 pandemic, poor sanitation is leading typhoid cases to a surge and obsolete diagnostic methods are paving the way towards ir-rational pharmacotherapy. In particular, the overuse of azithromycin for the treatment of COVID-19 might impair one of the few remaining regimens against XDR. Facing COVID-19 and XDR at the same time can lead to a catastrophy, unless the government, the stakeholders and healthcare workers take joint action to improve sanitation, educate the public, vaccinate vulnerable groups and establish good diagnostic and management practices.

A skeleton in the closet: The implications of COVID-19 on XDR strain of typhoid in Pakistan