Article Text
Abstract
Objective To investigate whether the administration of antibiotics affect faecal excretion time in paediatric salmonellosis with different severity.
Methods Children with nontyphoid salmonellosis admitted to Kaohsiung Veterans General Hospital, Taiwan who consented to receive consecutive stool cultures every 4–7 days till two consecutive negative results between 2005 and 2013 were enrolled. Faecal excretion time was defined as the timeframe of the first positive stool culture and the first of two consecutive negative results. The Severity Score was used to stratify the patients as the severe, moderate and mild group according to their fever days before admission, band cells in peripheral blood and C-reactive protein. Patients were classified into no antibiotics (mild disease without antibiotic), concordant (severe patients receiving antibiotics active in vitro) and inappropriate therapy group (mild patients receiving antibiotics or severe patients receiving antibiotics resistant in vitro).
Results 53 patients were enrolled. Compared with no antibiotic group (n = 28), the concordant group (n = 11) had comparable faecal excretion time (12.36 vs 9.79 days), fever days after admission and hospital stay (2.45 vs 2.25; 6.45 vs 6.39 days). The inappropriate group (n = 14) had significantly longer faecal excretion time (24.50 vs 9.79 days), hospital stay (8.50 vs 6.39 days) and higher platelet count (333.43 vs 269.82 × 1,000/mm3) than no antibiotics group. With further multiple regression analysis, only inappropriate antibiotic use affected significantly (p = 0.008) on faecal excretion time.
Conclusions Antibiotics used in severe children with salmonellosis didn’t prolong faecal excretion time, but inadequate use of antibiotics prolonged faecal excretion time in Salmonellosis.