Role of antibiotic therapy on long-term germ excretion in faeces and digestive symptoms after Salmonella infection.
BACKGROUND
The role of antibiotic therapy on Salmonella faecal excretion is controversial. Acute Salmonella gastroenteritis induces long-lasting digestive symptoms in up to one-third of subjects. The role of antimicrobial therapy on persistent post-infectious symptoms is unknown.


OBJECTIVE
To investigate the role of antibiotic therapy on long-term germ faecal excretion and digestive symptoms after Salmonella infection.


METHODS
1543 subjects [518 aged between 3 and 5 years (35.3%); 950 between 6 and 10 years (64.7%) and 75 adults (4.9%)] involved in a single outbreak of Salmonella enteritis fulfilled the study criteria by repeating stool cultures and answering a symptom questionnaire 3 months post-infection.


RESULTS
327 subjects (21.2%) were treated with antibiotics during the acute infection [121 children aged 3-5 years (23.4%), 175 children aged 6-10 years (18.4%) and 31 adults (41.3%)]. Antibiotic treatment did not affect Salmonella excretion at any of the time points studied up to three months post-infection in any age group as compared to age-matched untreated controls. Persistent digestive symptoms were more common among the patients treated with antibiotics (9.5% vs. 2.9%; P=0.003).


CONCLUSIONS
Antibiotic therapy does not affect Salmonella enteritis excretion. Digestive symptoms after clearance of the infectious agent are significantly higher in patients treated with antibiotics during acute gastroenteritis.
Barbara
G
G
Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy. gbarbara@med.unibo.it
Stanghellini
V
V
Berti-Ceroni
C
C
De Giorgio
R
R
Salvioli
B
B
Corradi
F
F
Cremon
C
C
Corinaldesi
R
R
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D005243:Feces / Q000382:microbiology*; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy / Q000382:microbiology*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D012478:Salmonella Food Poisoning / Q000188:drug therapy* / Q000453:epidemiology; D012477:Salmonella enteritidis / Q000187:drug effects / Q000302:isolation & purification*; D011795:Surveys and Questionnaires; D013997:Time Factors
D000900:Anti-Bacterial Agents