Clinical definition:
A systemic disease caused by Salmonella species. Clinical features include fever, anorexia, headache, vomiting, constipation or diarrhoea, abdominal pain or tenderness, cough, delirium / altered level of consciousness, hepatomegaly or splenomegaly. Where available, the organism may be cultured from blood (first week of illness) or stool (after first week), urine or bone marrow. A chronic carrier state may occur with ongoing shedding of the organism in stool which may result in transmission to others via contaminated food or water.
Infant, Child & Adolescent | |||
| Preferred antibiotic choice | |||
| Drug | Formulation | Dosage | Duration |
| For patients with severe disease: Ceftriaxone (IV) | Powder for injection: 250 mg, 1 g (as sodium slat) in vial | 50 mg/kg/dose 12 hourly, maximum dose 2 g 12 hourly | 10 – 14 days |
| For mild/moderate disease or as step down therapy for severe disease based on clinical response and antibiotic susceptibility results, if available: Ciprofloxacin (PO) | Oral liquid: 250 mg/5 mL (anhydrous); Tablet: 250 mg (as hydrochloride) | 15 mg/kg/dose 12 hourly, maximum dose 500 mg 12 hourly | 10 – 14 days
(Total treatment duration including IV therapy, if applicable.) |
| Alternative antibiotic choice(s) or for confirmed drug allergy or medical contraindication | |||
| Drug | Formulation | Dosage | Duration |
| Ciprofloxacin (IV) | Solution for IV infusion: 2 mg/ mL (as hyclate) | 10 mg/kg/dose 8-12 hourly, maximum dose 400 mg 8-12 hourly | 10 – 14 days |
| Azithromycin (PO) | Capsule: 250 mg; 500 mg (anhydrous). Oral liquid: 200 mg/5 mL | 10 mg/kg/dose daily, maximum dose 500 mg | 5 days |
Principles of Stewardship:
- The patient should ideally be isolated with contact precautions maintained until eradication of the organism from the stool is confirmed on 3 stool samples taken 1 week after completion of antibiotic treatment and every 48 hours thereafter to detect chronic carriage and excretion of the organism.
Notes:
- Prolonged therapy (4 – 6 weeks) is recommended in invasive disease, including bone infections, and in immunocompromised patients (including HIV infection)