From the Guidelines
Antibiotics are not typically needed for most cases of food poisoning caused by chicken left out too long. Food poisoning from improperly stored chicken is usually caused by bacteria like Salmonella or Campylobacter, which generally resolve on their own within 2-7 days 1. According to the 2017 Infectious Diseases Society of America clinical practice guidelines, empiric antimicrobial therapy for bloody diarrhea is not recommended in immunocompetent children and adults, except in specific situations such as infants <3 months of age, ill immunocompetent people with fever, abdominal pain, and bloody diarrhea, or people who have recently travelled internationally with signs of sepsis 1.
Instead, focus on staying hydrated with water, clear broths, or oral rehydration solutions to replace lost fluids and electrolytes. Rest your digestive system by avoiding solid foods initially, then gradually reintroduce bland, easy-to-digest foods like toast, bananas, rice, and applesauce as you begin to feel better. Over-the-counter medications such as loperamide (Imodium) can help control diarrhea, while acetaminophen (Tylenol) may reduce fever and discomfort.
Key considerations for seeking medical attention include:
- Severe symptoms like high fever (over 102°F/38.9°C)
- Bloody diarrhea
- Severe abdominal pain
- Signs of dehydration (extreme thirst, dry mouth, little or no urination, severe weakness)
- Symptoms persisting beyond a week In these situations, antibiotics may be prescribed, but only if necessary and based on the specific circumstances and test results 1. Unnecessary antibiotic use can worsen some infections and contribute to antibiotic resistance, so it's essential to follow guidelines and consult a healthcare professional for proper evaluation and treatment.
From the FDA Drug Label
Infectious Diarrhea caused by Escherichia coli (enterotoxigenic strains), Campylobacter jejuni, Shigella boydii†, Shigella dysenteriae, Shigella flexneri or Shigella sonnei† when antibacterial therapy is indicated.
The use of antibiotics, such as ciprofloxacin, may be indicated for infectious diarrhea caused by certain bacteria, including Escherichia coli and Campylobacter jejuni, which can be associated with food poisoning from contaminated chicken. However, antibiotics are only recommended when antibacterial therapy is indicated. Key considerations include:
- The cause of the diarrhea must be bacterial in nature
- The bacteria must be susceptible to the antibiotic
- Appropriate culture and susceptibility tests should be performed before treatment to guide therapy 2
From the Research
Food Poisoning and Antibiotics
- If you are suspecting food poisoning due to chicken being left on the counter for too long, the need for antibiotics depends on the type of bacteria causing the infection.
- According to a study on antimicrobials for treating symptomatic non-typhoidal Salmonella infection 3, there is no evidence of benefit for antibiotics in non-typhoidal Salmonella (NTS) diarrhoea in otherwise healthy people.
- Another study on antibiotics for treating salmonella gut infections 4 found that antibiotic therapy does not shorten the length of illness, diarrhoea, or fever in people with salmonella infections, and may even increase adverse effects and prolong salmonella detection in stools.
Antibiotic Treatment for Salmonella Infections
- A study on the treatment responses to Azithromycin and Ciprofloxacin in uncomplicated Salmonella Typhi infection 5 found that azithromycin is associated with prolonged bacteraemia and fever clearance times compared to ciprofloxacin.
- However, another study on the antimicrobial susceptibility to azithromycin among Salmonella enterica Typhi and Paratyphi A isolates from India 6 found that azithromycin may be a useful alternative oral agent in endemic areas where decreased ciprofloxacin susceptibility is common.
- A more recent study on the potential clinical use of azithromycin against gastroenteritis-causing pathogens other than Campylobacter 7 found that azithromycin may be a good empirical therapeutic option for the treatment of bacterial enteritis, including infections caused by Salmonella spp.