Antimicrobials for treating symptomatic non-typhoidal Salmonella infection

摘要: Background Non-typhoidal Salmonella (NTS) commonly causes diarrhoea, and is usually self-limiting, although sometimes people become ill with sepsis dehydration. Routine antibiotic use for this infection could result in persistent colonization the spread of resistant bacterial strains. Objectives To assess efficacy safety giving antibiotics to NTS diarrhoea. Search methods We searched Cochrane Infectious Diseases Group trials register (up August 2012), Controlled Trials Register (CENTRAL) published The Library Issue 8 2012); MEDLINE, African Index Medicus, CINAHL, EMBASE, LILACS, Science Citation Index, all up 6 2012. We also metaRegister (mRCT) both completed on going reference lists relevant articles. Selection criteria Randomized controlled (RCTs) comparing any treatment diarrhoea caused by species placebo or no treatment. selected that included ages who were symptomatic infection. Examples symptoms fever, abdominal pain, vomiting diarrhoea. excluded where outcomes not reported separately subgroup patients. Two review authors independently applied eligibility criteria prior study inclusion. Data collection analysis Two extracted data pre-specified assessed risk bias studies. primary outcome was presence between two four days after quality evidence using GRADE methods. Main results Twelve involving 767 participants included. No differences detected placebo/no arms at (risk ratio (RR) 1.75, 95% confidence interval (CI) 0.42 7.21; one trial, 46 participants; very low evidence). difference five seven (RR 0.83, CI 0.62 1.12; trials, 192 evidence), clinical failure 0.88, 1.25; 440 mean 0 (95% -0.54 0.54; 202 participants, studies; evidence);for fever 0.27 -0.11 0.65; 107 evidence); duration illness -0.68 0.68; 116 Quinolone resulted a significantly higher number negative stool cultures during first week (microbiological failure: RR 0.33, 0.20 0.56; 166 trials). Antibiotic meant passage same serovar month almost twice as likely 1.96, 1.29 2.98; 112 three trials), which statistically significant. Non-severe adverse drug reactions more common among patients received treatment. Authors' conclusions There benefit otherwise healthy people. are uncertain effects young people, old severe extraintestinal disease. A slightly events noted NTS.