Table 3. Recommended
Antimicrobial Therapy for Non-Typhoid Salmonella Infection
|
Infections |
Recommendations |
|
Enteric infection |
Not recommended routinely, but if severe or patient is < 3 months or > 50 years old or has prostheses, valvular heart disease, severe atherosclerosis, malignancy, or uremia: trimethoprim-sulfamethoxazolea or ciprofloxacinb or ceftriaxonec for 3-5 days or until the patient becomes afebrile; for immunocompromised patients, 14 days or longer if relapsing. |
|
Bacteremia |
Bacteremia not involving vascular structures should be treated with 10 to 14 days with ceftriaxonec or ciprofloxacind or ampicilline. For patients with HIV infection, 1 to 2 weeks of intravenous antimicrobial therapy followed by 4 weeks of oral fluoroquinolone therapyb should be administered; long-term suppressive therapy with an oral fluoroquinolone needed for patients who relapse following 6 weeks of antimicrobial therapy. |
|
Extraintestinal focal infection |
Patients with bone and joint infection need 4-6 weeks therapy with either ceftriaxonec or ciprofloxacind. Patients with meningitis should be treated with ceftriaxonef for 4 weeks or longer. Surgery along with 6-8 weeks of ampicilline or ceftriaxonec is recommended to treat endovascular infection (mycotic aneurysm). |
a 160 and 800 mg po twice daily (pediatric dose: 5 and 25 mg/kg/dose twice daily).
b 500-750 mg po twice daily.
c 2 gm iv daily in 1-2 divided doses (pediatric dose: 50-75 mg/kg/day in 1-2 divided doses).
d 400 mg iv twice daily. Fluoroquinolones not yet approved for pediatric use in Salmonella infection.
e 2 gm iv four to six times daily (pediatric dose: 100-200 mg/kg/day in 4 divided doses).
f 4 gm iv daily in 1-2 divided doses (pediatric dose: 100 mg/kg/day in 1-2 divided doses).