Treatment for Salmonella Infection
Salmonella infections usually resolve in five to seven days, and many times require no treatment unless the patient becomes severely dehydrated or the infection spreads from the intestines. Persons with severe diarrhea may require re-hydration, often with intravenous fluids.
Treatment with antibiotics is not usually necessary; however, if the infection spreads from the intestines, or otherwise persists, the infection can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, ceftriaxone, amoxicillin, or ciprofloxacin. The length of treatment varies depending on the extent of a patient’s illness, and can range from 14 days for enteric fever to six weeks for bactremia (Mayo Clinic, 2007, April 12). Some Salmonella bacteria have become antibiotic-resistant.
Consult your healthcare provider if you believe you have become ill with salmonellosis.
Antimicrobial Resistance in Salmonella Bacteria
Antimicrobial resistance in bacteria is an emerging and increasing threat to human health. Physicians should be aware that antimicrobial resistance is increasing in foodborne pathogens and that patients who are prescribed antibiotics are at increased risk for acquiring antimicrobial-resistant foodborne infections. In addition, “…increased frequency of treatment failures for acute illness and increased severity of infection may be manifested by prolonged duration of illness, increased frequency of bloodstream infections, increased hospitalization or increased mortality,” (Angulo, Nargund, & Chiller, 2004).
The use of antimicrobial agents in the feed of food animals is estimated by the FDA to be over 100 million pounds per year. Estimates range from 36 to 70 percent of all antibiotics produced in the United States are used in a food animal feed or in prophylactic treatment to prevent animal disease. In 2002, the Minnesota Medical Association published an article by David Wallinga, M.D., M.P.H. who wrote:
According to the [Union of Concerned Scientists], 70 percent of all the antimicrobials used in the United States for all purposes—or about 24.6 million pounds annually—are fed to poultry, swine, and beef cattle for nontherapeutic purposes, in the absence of disease. Over half are “medically important” antimicrobials, identical or so closely related to human medicines that resistance to the animal drug can confer resistance to the similar human drug. Penicillins, tetracyclines, macrolides, streptogramins, and sulfonamides are prominent examples. (Wallinga, 2002).
The National Antimicrobial Resistance Monitoring System (NARMS) reported that Campylobacter has been recovered from 47 percent of chicken breasts tested in recent studies. In the same NARMS studies, five multi-drug resistant strains of Salmonella Newport were recovered from ground beef, ground turkey, and pork chops.
According to the report, “…antimicrobial resistance among these foodborne bacteria is not uncommon and often associated with the use of antimicrobial agents in food animals,” (Stevenson, et al., 2002). Ceftriaxone-resistant Salmonella has also been reported (Fey et al., 2000). The emergence of multidrug-resistant Salmonella typhimurium in the United States is another example of a drug-resistant bacteria spreading from animals to humans (Glynn et al., 1998). CDC reports:
A large proportion of serotype Typhimurium isolates were resistant to multiple antimicrobial drugs; in a 2003 national survey, 45% were resistant to one or more drugs and 26% had a five-drug resistance pattern characteristic of a single phage type, DT104 (2). Similarly, serotype Newport has emerged as a major multidrug-resistant pathogen (CDC, 2007).
The use of antibiotics in feed for food animals, on animals prophylactically to prevent disease, and the use of antibiotics in humans unnecessarily must be reduced. European countries have reduced the use of antibiotics in animal feed and have seen a corresponding reduction in antibiotic-resistant illnesses in humans (Angulo, Baker, et al., 2004).