Reappraisal of parenteral antimicrobial therapy for nontyphoidal Salmonella enteric infection in children

M. H. Tsai, Y. C. Huang, T. Y. Lin, Y. L. Huang, C. C. Kuo, C. H. Chiu

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Increasing antimicrobial resistance in nontyphoidal Salmonella (NTS) species complicates the use of antibiotics if indicated. We investigated the impact of antimicrobial resistance on clinical outcomes and discussed how to use antibiotics rationally. Hospitalized children in 2005-2006 with stool cultures positive for NTS were identified. The clinical and microbiological features were retrospectively reviewed. A total of 683 children were included [371 (54.3%) male; 89.5% <5years of age]. Antibiotics were given to 56.5% of the patients; third-generation cephalosporin was the most commonly used drug class. Cases receiving antibiotics that were inactive in vitro did not have more complications than those receiving antibiotics active in vitro. Complications occurred in 7.9% of the patients, with bacteraemia being the most common (57.4%). Compared to the others, patients with longer febrile duration and higher C-reactive protein (CRP) levels (CRP ≥100mg/L) were more frequently put on empirical antimicrobial therapy and had more complications. These patients usually had shorter hospitalization and duration of fever if antimicrobial agents that can reach high tissue concentrations in the intestinal mucosa were administered, such as fluoroquinolone or ceftriaxone. It is concluded that adequate antibiotics may be clinically beneficial to a subset of patients with high CRP and longer duration of fever among children with NTS enteritis. To prevent the induction of antibiotic resistance from this therapy, we suggested a short course (3-5days) of intravenous ceftriaxone for such patients, which would lead to a faster clinical recovery.

Original languageEnglish
Pages (from-to)300-305
Number of pages6
JournalClinical Microbiology and Infection
Volume17
Issue number2
DOIs
Publication statusPublished - Feb 2011
Externally publishedYes

Fingerprint

Salmonella Infections
Anti-Bacterial Agents
Salmonella
C-Reactive Protein
Fever
Ceftriaxone
Therapeutics
Hospitalized Child
Enteritis
Fluoroquinolones
Cephalosporins
Intestinal Mucosa
Microbial Drug Resistance
Bacteremia
Anti-Infective Agents
Protein C
Hospitalization
Pharmaceutical Preparations

Keywords

  • Antimicrobial therapy
  • Children
  • Complication
  • Enteric infection
  • Nontyphoidal Salmonella

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Reappraisal of parenteral antimicrobial therapy for nontyphoidal Salmonella enteric infection in children. / Tsai, M. H.; Huang, Y. C.; Lin, T. Y.; Huang, Y. L.; Kuo, C. C.; Chiu, C. H.

In: Clinical Microbiology and Infection, Vol. 17, No. 2, 02.2011, p. 300-305.

Research output: Contribution to journalArticle

Tsai, M. H. ; Huang, Y. C. ; Lin, T. Y. ; Huang, Y. L. ; Kuo, C. C. ; Chiu, C. H. / Reappraisal of parenteral antimicrobial therapy for nontyphoidal Salmonella enteric infection in children. In: Clinical Microbiology and Infection. 2011 ; Vol. 17, No. 2. pp. 300-305.
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