Salmonella Gastroenteritis
In a carefully controlled prospective study, 44 patients with uncomplicated Salmonella gastroenteritis were treated with ampicillin, or amoxicillin, or placebo. Antibiotics had no effect on duration of diarrhea or on the persistence or disappearance of Salmonella from stool cultures. Bacteriologic (and less often clinical) relapse occurred only in the antibiotic-treated groups. "It is concluded that ampicillin or amoxicillin therapy provides no benefit to patients with uncomplicated Salmonella gastroenteritis and substantially increases the risk of bacteriologic and symptomatic relapse."
Comment: Some exceptions to the latter rule exist: patients with ulcerative colitis, immunocompromised hosts, and perhaps the infant less than 3 months of age. Davis (Am J Dis Child 135:1096, 1981) notes that such infants are at substantial risk for serious metastatic complications (such as meningitis) and clinicians should consider antibiotics here in hopes of keeping the Salmonella confined to the gastrointestinal tract.
