From the Research
Salmonella food poisoning does not always require medical treatment. Most healthy individuals can recover from salmonella infection without specific treatment within 4-7 days by resting and staying hydrated 1. For mild to moderate cases, home care focusing on drinking plenty of fluids to prevent dehydration is usually sufficient. However, medical attention is necessary in certain situations:
- if you have severe symptoms (high fever over 102°F, bloody diarrhea, severe vomiting preventing fluid intake)
- if symptoms last longer than a week
- if you're dehydrated (signs include decreased urination, dry mouth, dizziness)
- or if you belong to a high-risk group (infants, older adults, pregnant women, or people with weakened immune systems) 2. When treatment is needed, antibiotics such as ciprofloxacin or azithromycin may be prescribed, typically for 5-7 days 3. Antibiotics are generally reserved for severe cases or high-risk individuals because they can sometimes prolong the period of bacterial shedding. The reason most cases resolve without treatment is that the immune system can effectively fight the infection, and the body's natural defenses work to eliminate the bacteria while symptoms gradually improve 4.
According to a recent systematic review, azithromycin and ceftriaxone were found to be more effective in treating Salmonella infections based on the patient's length of stay in the hospital and the rate at which the fever was resolved 3. However, the use of antibiotics should be judicious and based on the severity of the infection and the patient's risk factors. In general, the management of salmonellosis involves a comprehensive approach, including prevention of transmission, proper handling of food, and avoidance of cross-contamination 1.
It's worth noting that the emergence of antibiotic-resistant Salmonella strains has highlighted the need for alternative approaches to infection control 4. Nevertheless, in the context of real-life clinical practice, the decision to treat salmonella food poisoning should prioritize the patient's morbidity, mortality, and quality of life, taking into account the latest evidence and guidelines 3, 2, 1, 4.