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.