Treatment of Salmonella-Positive Patients

Patient Management

For immunocompetent adults and children over 3 months with uncomplicated Salmonella gastroenteritis, the American College of Physicians recommends providing only oral rehydration and supportive care, without antibiotics 1, 2, 3
The Infectious Diseases Society of America recommends treatment with antibiotics for infants less than 3 months of age, as bacteremia risk reaches 45% in neonates and 11% in older infants, with high risk of meningitis and osteomyelitis 2, 3
The Centers for Disease Control and Prevention recommends treatment with antibiotics for all immunocompromised patients, including those with HIV/AIDS, transplant recipients, chronic immunosuppression, or malignancy 1, 3, 4
The World Health Organization recommends treatment with antibiotics for patients with documented bacteremia or sepsis, as well as those with severe invasive disease, including fever ≥38.5°C, signs of sepsis, or suspected enteric fever 1, 3
The American College of Obstetricians and Gynecologists recommends treatment with antibiotics for pregnant women, due to the risk of placental infection and pregnancy loss 3, 4

The Infectious Diseases Society of America recommends ciprofloxacin 500 mg PO twice daily for 7-14 days as a first-line treatment for adults with uncomplicated Salmonella gastroenteritis 3, 4
The American College of Physicians recommends azithromycin as an alternative treatment for adults with uncomplicated Salmonella gastroenteritis, based on local resistance patterns 1
The Centers for Disease Control and Prevention recommends ceftriaxone 2 g IV once daily plus ciprofloxacin 500 mg PO twice daily until susceptibilities are available, for immunocompromised adults and those with severe invasive disease 3, 4

The World Health Organization recommends reduced osmolarity ORS as first-line treatment for mild-moderate dehydration, until clinical correction, then continue to replace ongoing losses 1, 2
The American Academy of Pediatrics recommends resuming age-appropriate diet immediately after rehydration, and continuing breastfeeding throughout illness if applicable 2

The Centers for Disease Control and Prevention recommends hand hygiene with soap and water after toilet use, diaper changes, before food preparation, and after animal contact, to prevent the spread of Salmonella infection 2, 4
The American Academy of Pediatrics recommends excluding patients from swimming and water activities until diarrhea resolves, to prevent the spread of Salmonella infection 2