Approach to antibiotic therapy for Salmonella enteritis

If antibiotic therapy is indicated for nontyphoidal Salmonella enteritis, oral therapy is usually preferred. Initial intravenous therapy is recommended for patients:

• unable to tolerate or absorb oral therapy
• younger than 3 months
• with extraintestinal infection (eg bacteraemia, endovascular infection, meningitis, osteoarticular infection)
• with sepsis or septic shock.

For patients with nontyphoidal Salmonella enteritis who have sepsis or septic shock, start antibiotic therapy within 1 hour of presentation to medical care or, for ward-based patients, development of sepsis or septic shock. Antibiotics should be administered immediately after blood samples are taken for culture. For nonantibiotic management of sepsis or septic shock, see Resuscitation of patients with sepsis or septic shock.