From the Guidelines
The treatment course for salmonella typically lasts 7-14 days for mild cases, and up to 2-6 weeks for patients with advanced HIV disease or severe infections. When antibiotics are needed, common options include ciprofloxacin, azithromycin, or trimethoprim-sulfamethoxazole 1. For severe or invasive infections, treatment may extend to 14 days or longer, especially for typhoid fever or if the infection spreads beyond the intestines. Some key points to consider in the treatment of salmonella include:
- The use of antibiotics such as sulphamethoxazole/trimethoprim and/or ceftriaxone or carbapenems alone or in association, with specialist advice taken as needed 1
- The potential need to prolong antibiotics until the disappearance of all lesions, especially in immunocompromised patients or those with neurological involvement 1
- The importance of managing symptoms and preventing complications in vulnerable populations, while minimizing the risk of prolonging the carrier state 1
- The consideration of withholding immunomodulators until resolution of the active infection, as immunomodulator therapy is considered a high-risk predisposing condition for intestinal or systemic infections with Salmonella spp. 1
From the Research
Treatment Course for Salmonella
The treatment course for salmonella can vary depending on the severity of the infection and the antibiotic used.
- For uncomplicated salmonella enteritis, a study published in 1993 found that patients were treated with ciprofloxacin, trimethoprim-sulfamethoxazole, or placebo orally twice daily for 5 days 2.
- Another study published in 2013 suggested that a short-course ceftriaxone therapy (3-5 days) may lead to faster clinical recovery in patients with severe gastroenteritis 3.
- A study published in 2019 compared the treatment responses to azithromycin and ciprofloxacin in uncomplicated Salmonella Typhi infection, and found that azithromycin was given at a dose of 500mg daily for 14 days, while ciprofloxacin was given at a dose of 500mg twice-daily for 14 days 4.
- A review published in 2000 discussed the efficacy of conventional antimicrobials and fluoroquinolones in treating uncomplicated Salmonella gastroenteritis, but did not specify a particular treatment course 5.
- A study published in 1980 treated infants and children with ampicillin, amoxicillin, or placebo for five days, with a dosage of 100 mg/kg/day in four equally divided doses 6.
Duration of Treatment
The duration of treatment for salmonella can vary from 3-5 days for severe gastroenteritis to 14 days for uncomplicated Salmonella Typhi infection.
- A short-course ceftriaxone therapy (3-5 days) may be used for severe gastroenteritis 3.
- Azithromycin and ciprofloxacin were given for 14 days in a study published in 2019 4.
- A five-day treatment course was used in a study published in 1980 6.
- A five-day treatment course was also used in a study published in 1993 2.