Antibiotics for treating salmonella gut infections

  • Review
  • Intervention

Authors

  • Sayomporn Sirinavin,

    Corresponding author
    1. Mahidol University, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand
    • Sayomporn Sirinavin, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama 6, Bangkok, 10400, Thailand. rassr@mahidol.ac.th.

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  • Paul Garner

    1. Liverpool School of Tropical Medicine, International Health Group, Liverpool, Merseyside, UK
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Abstract

Background

Antibiotic treatment of salmonella infections aims to shorten illness and prevent serious complications. There are also concerns about increasing antibiotic drug resistance.

Objectives

The objective of this review was to assess the effects of antibiotics in adults and children with diarrhoea who have salmonella.

Search methods

We searched the Cochrane Infectious Diseases Group trials register, the Cochrane Controlled Trials Register, Medline, Science Citation Index, African Index Medicus, Lilacs, Extra Med and reference lists of relevant articles. We also contacted experts in the field.

Selection criteria

Randomised and quasi-randomised trials comparing antibiotic therapy with placebo or no antibiotic therapy for salmonella infections in symptomatic or asymptomatic adults or children. Typhoid and paratyphoid salmonella infections were excluded.

Data collection and analysis

Trial quality assessment and data were extracted independently by two reviewers.

Main results

Twelve trials involving 778 participants (with at least 258 infants and children) were included. There were no significant differences in length of illness, diarrhoea or fever between any antibiotic regimen and placebo. The weighted mean difference for length of illness was -0.07 days, 95% confidence interval -0.55 to 0.40; diarrhoea -0.03 days, 95% confidence interval -0.53 to 0.48; fever -0.45 days, 95% confidence interval -0.98 to 0.08. Antibiotic regimens resulted in more negative cultures during the first week of treatment. Relapses were more frequent in those receiving antibiotics, and there were more cases with positive cultures in the antibiotic groups after three weeks. Adverse drug reactions were more common in the antibiotic groups (Peto odds ratio 1.67, 95% confidence interval 1.05 to 2.67).

Authors' conclusions

There appears to be no evidence of a clinical benefit of antibiotic therapy in otherwise healthy children and adults with non-severe salmonella diarrhoea. Antibiotics appear to increase adverse effects and they also tend to prolong salmonella detection in stools.

摘要

背景

抗生素治療腸道感染沙門氏桿菌

抗生素治療沙門氏桿菌感染的目的是希望縮短病程和防止嚴重的併發症,但越來越常見的抗生素抗藥性也值得注意。

目標

此回顧之目的是評估在有沙門氏桿菌感染合併腹瀉的成人和兒童之抗生素使用影響。

搜尋策略

我們搜尋了Cochrane傳染病組試驗登記、對照試驗登記、Medline、科學引文索引、African Index Medicus、Lilacs、Extra Med 與 相關文章的引用文獻;我們還連絡了該領域的專家。

選擇標準

隨機和準隨機試驗在有或無症狀沙門氏桿菌感染的成年人或兒童比較抗生素治療與安慰劑或無抗生素治療;傷寒與副傷寒沙門桿菌感染則被排除在外。

資料收集與分析

試驗品質評估和數據擷取是由兩個評論者獨立完成。

主要結論

十二試驗有778人參予者(至少258個嬰兒和兒童)被列入;在各種抗生素處方和安慰劑比較,病程長度、腹瀉或發燒方面沒有顯著差異,加權平均差異如下:病程長度為0.07天,95 %的信賴區間為−0.55至0.40;腹瀉為0.03天,95 %的信賴區間為−0.53至0.48;發燒為0.45天, 95 %的信賴區間−0.98至0.08。抗生素處方造成第一週治療期間細菌培養為陰性,疾病的復發在那些接受抗生素的病人更為頻繁,且有更多的病人在抗生素治療三個星期後細菌培養為陽性。藥物不良反應在接受抗生素組更為常見(Peto勝算比為1.67,95 %的信賴區間為1.05至2.67)。

作者結論

在非嚴重型沙門氏桿菌腹瀉的健康兒童和成人的抗生素治療上面似乎並無證據顯示其臨床效果;使用抗生素似乎會增加了不良反應發生,也往往延長在糞中檢測出沙門氏桿菌的時間。

翻譯人

本摘要由三軍總醫院盧俊吉翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

等候摘要。

Plain language summary

Antibiotics for treating salmonella gut infections

Plain language summary pending.

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