Treatment of Salmonella Infection Symptoms

Fluid and Electrolyte Management

Oral rehydration solution (ORS) should be administered until clinical dehydration is corrected, followed by maintenance fluids to replace ongoing losses, as recommended by the Infectious Diseases Society of America 2
Intravenous fluids may be necessary for patients with severe dehydration or those unable to tolerate oral intake, according to the Infectious Diseases Society of America 2
All patients with Salmonella infection should be evaluated for dehydration, which increases the risk of life-threatening illness and death, especially among young children and older adults, as stated by the Infectious Diseases Society of America 3

Antimotility drugs (e.g., loperamide) should NOT be given to children <18 years of age with acute diarrhea, as recommended by the American Academy of Pediatrics and the Infectious Diseases Society of America 1, 2
Loperamide may be given to immunocompetent adults with acute watery diarrhea but should be avoided in cases of inflammatory diarrhea or diarrhea with fever, which is common with Salmonella infection, according to the Infectious Diseases Society of America 1, 2
Antinausea and antiemetic medications (e.g., ondansetron) may be given to facilitate oral rehydration tolerance in children >4 years of age and adolescents with vomiting, as recommended by the American Academy of Pediatrics and the Infectious Diseases Society of America 1, 2
Probiotic preparations may be offered to reduce symptom severity and duration in immunocompetent adults and children, according to the Infectious Diseases Society of America 1, 2

Patients with signs of invasive disease or sepsis should be treated with antibiotics, as recommended by the Infectious Diseases Society of America 4, 5
Patients with severe disease or risk factors for complications should be considered for antibiotic treatment, according to the Infectious Diseases Society of America 4, 6

Hand hygiene should be performed after using the toilet, changing diapers, before and after preparing food, and before eating, as recommended by the Centers for Disease Control and Prevention and the Infectious Diseases Society of America 2
Appropriate food safety practices should be followed to avoid cross-contamination, according to the Centers for Disease Control and Prevention and the Infectious Diseases Society of America 2
Ill people with diarrhea should avoid swimming, water-related activities, and sexual contact with others while symptomatic, as recommended by the Centers for Disease Control and Prevention and the Infectious Diseases Society of America 2

Follow-up testing is not recommended in most people following resolution of diarrhea, but may be required in certain situations by local health authorities, as stated by the Infectious Diseases Society of America 6
Patients who do not respond to initial management should be reassessed for possible complications or alternative diagnoses, according to the Infectious Diseases Society of America 6

Using antimotility agents in children or in adults with inflammatory diarrhea can mask worsening symptoms and potentially lead to serious complications, as warned by the American Academy of Pediatrics and the Infectious Diseases Society of America 1, 2
Failing to adequately rehydrate patients is the cornerstone of management and can lead to severe dehydration, as emphasized by the Infectious Diseases Society of America 2
Not considering Salmonella infection in patients with fever and abdominal pain, especially those with relevant travel or exposure history, can delay diagnosis and treatment, as noted by the Infectious Diseases Society of America 3