The clinical outcomes of antimicrobial therapy in pediatric patients with nontyphoid salmonellosis with different levels of severity

Clin Pediatr (Phila). 2014 Sep;53(10):967-74. doi: 10.1177/0009922814540792. Epub 2014 Jul 7.

Abstract

Background: To evaluate if a severity score could differentiate the severity of children with nontyphoid salmonellosis; clinical outcomes of antimicrobial therapy in nontyphoid salmonellosis children with different severities.

Methods: Admitted children with nontyphoid salmonellosis from 1996 to 2009 were monitored. Enrolled patients were divided into no antibiotics, concordant, and discordant therapies. Besides, the patients were classified into mild, moderate, and severe group according to the severity score. Clinical outcomes were compared among them.

Results: A total of 558 patients were enrolled. In no therapy subset, compared with mild group, patients had worse clinical outcomes and more complications in severe group. Patients receiving no therapy had better clinical outcomes in mild group. However, patients receiving concordant therapy (ceftriaxone) had better clinical outcomes in severe group.

Conclusions: The severity score and local antibiotic susceptibility could serve as guides for antibiotic prescription for severe nontyphoid salmonellosis in children. Inappropriate antibiotic use would worsen clinical outcomes in children with mild nontyphoid salmonellosis.

Keywords: antibiotics; children; different severity; nontyphoid salmonellosis.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adolescent
  • Algorithms
  • Anti-Bacterial Agents / therapeutic use*
  • Anti-Infective Agents / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Resistance, Bacterial*
  • Female
  • Humans
  • Infant
  • Length of Stay
  • Male
  • Practice Guidelines as Topic
  • Prospective Studies
  • Risk Factors
  • Salmonella / classification
  • Salmonella / drug effects*
  • Salmonella / isolation & purification
  • Salmonella Infections / diagnosis*
  • Salmonella Infections / drug therapy*
  • Salmonella Infections / microbiology
  • Severity of Illness Index
  • Taiwan
  • Tertiary Care Centers
  • Treatment Failure
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents