Duration of antimicrobial therapy for non-typhoid Salmonella bacteremia in healthy children.
Medical records of patients less than 17 years of age with positive blood culture for non-typhoid Salmonella from June 1996 through December 1998 at the Chang Gung Children's Hospital were collected. Patients were categorized into 3 groups according to the duration of effective antibiotic therapy they received. Group 1 received effective antibiotic therapy for less than 7 days; Group 2 for 7 to 9 days; and Group 3 for 10 days or more. Information on clinical presentations, laboratory data, and outcome were collected and analyzed. A total of 59 children were eligible, with 21 in Group 1, 17 in Group 2, and 21 in Group 3. Demographic data were similar among the 3 groups. No significant difference was found in the clinical symptoms and laboratory data among these groups, including white blood cell count, immature to total ratio of white blood cell, and serum C-reactive protein level. Salmonella group B (n = 37) were the most common isolates, followed by group D (n = 9), group C2 (n = 8), cholerasuis (n = 4), and C1 (n = 2). Third-generation cephalosporins were the final antibiotic therapy in most (90%) patients, and no isolates showed resistance to these agents in this study. No focal suppurative complications were noted at the initial evaluation and in the 1-year period after treatment. No clinical recurrent diseases were noted during a follow-up period of at least 1 year. Results suggest that for otherwise healthy children with non-typhoid Salmonella bacteremia, less than 10 days of antibiotics therapy could be adequate if they are more than 1 year old and no focal extra-intestinal infection is noted in the initial evaluation.
Yen
Meng-Hsin
MH
Department of Pediatric Infectious Disease, Chang Gung Children's Hospital, Taoyuan, Taiwan, ROC.
Huang
Yhu-Chering
YC
Chiu
Cheng-Hsun
CH
Lin
Tzou-Yien
TY
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D016470:Bacteremia / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012480:Salmonella Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents