Only treat severe cases
“Salmonella is a common cause of gastroenteritis. Transmission is most often associated with eggs, poultry, undercooked ground meat, and dairy products from contaminated animals, or produce contaminated by their waste. Salmonella infection is usually associated with nausea, vomiting, diarrhea, and fever starting 6–48 hours after ingestion of contaminated water or food. Stools are usually moderate-volume, loose, and nonbloody, although they can be large-volume watery stools with blood. While Salmonella can cause severe infection, it is usually self-limited. Antibiotics should not be routinely used to treat uncomplicated Salmonella gastroenteritis and may prolong the duration of Salmonella excretion in stool. Antibiotic treatment should be reserved for patients who are severely ill or suspected of being bacteremic. The threshold for treatment should also be decreased in those who are considered to be at higher risk for severe illness and invasive disease, such as infants, the elderly, patients with sickle cell disease, and immunosuppressed patients. Chronic fecal carriers of Salmonella may also benefit from treatment. If treatment is required, ciprofloxacin, ampicillin, ceftriaxone, and trimethoprim/sulfamethoxazole are all treatment options.
Kasper DL, Fauci AS, Hauser SL, et al (eds): Harrison’s Principles of Internal Medicine, ed 19. McGraw-Hill, 2015, pp 1049-1055. 2) Kliegman RM, Stanton BF, Geme JW III, et al (eds): Nelson Textbook of Pediatrics, ed 20. Elsevier Saunders, 2016, pp 1382-1393.” ABFM critique