Salmonella















































Syndrome Suggested therapy
Gastroenteritis
Normal host Rehydration
Normal host with severe disease or risk factors Levofloxacin, 500 mg (or other fluoroquinolone) once a day for 7–10 d; or azithromycin, 500 mg once a day for 7 d
Immunocompromised adult Levofloxacin, 500 mg (or other fluoroquinolone) once a day for 14 days; or azithromycin, 500 mg once a day for 14 d
Neonate or immunocompromised child None or ceftriaxone, 100 mg/kg/d in two equally divided daily doses for 7–10 d; or azithromycin, 20 mg/kg/d once a day for 7 d
Typhoid fever
Adult, sensitive strain Ciprofloxacin, 500 mg PO or IV BID for 5–7 d
Adult, intermediate strainsa Ciprofloxacin, 750 mg PO or IV BID for 5–7 d
Adult, resistant strainsb Ceftriaxone, 2 g IV qd for 10–14 d; or azithromycin, 500 mg PO or IV qd for 7 d
Children, pregnant women Ceftriaxone, 100 mg/kg/d in two equally divided daily doses for 10–14 d; or azithromycin, 20 mg/kg/d once a day for 7 d
All patients with severe typhoid fever (delirium, obtundation, stupor, coma, or shock) should receive dexamethasone, 3 mg/kg initially, followed by 1 mg/kg q6h for 48 h
Chronic carrier
Adult Ciprofloxacin, 750 mg PO BID for 4 wk; or amoxicillin, 1 g PO TID for 3 mo; or TMP–SMX, 160/800 mg PO BID for 3 mo
Children Amoxicillin, 40 mg/kg PO up to 1 g TID for 3 mo; or TMP–SMX, 5 mg/kg TMP BID for 3 mo



Abbreviations: TMP–SMX = trimethoprim–sulfamethoxazole; MIC = minimum inhibitory concentration.




a MIC to ciprofloxacin of 0.125 to 1 μg/mL.



b MIC values to ciprofloxacin of 2 μg/mL or greater.



Typhoid fever

Fluoroquinolones are the agents of choice for treatment of typhoid fever. They are more rapidly effective and are associated with lower rates of relapse and stool carriage than chloramphenicol, ampicillin, and TMP–SMX. They are also felt to be more effective than ceftriaxone. Strains sensitive to nalidixic acid can be treated with

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Jun 18, 2016 | Posted by in INFECTIOUS DISEASE | Comments Off on Salmonella

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