Role of antibiotic therapy on long‐term germ excretion in faeces and digestive symptoms after Salmonella infection

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Abstract
Background: The role of antibiotic therapy on Salmonella faecal excretion is controversial. Acute Salmonella gastroenteritis induces long‐lasting digestive symptoms in up to one‐third of subjects. The role of antimicrobial therapy on persistent post‐infectious symptoms is unknown.Aim: To investigate the role of antibiotic therapy on long‐term germ faecal excretion and digestive symptoms after Salmonella infection.Subjects and methods: 1543 subjects [518 aged between 3 and 5 years (35.3%); 950 between 6 and 10 years (64.7%) and 75 adults (4.9%)] involved in a single outbreak of Salmonella enteritis fulfilled the study criteria by repeating stool cultures and answering a symptom questionnaire 3 months post‐infection.Results: 327 subjects (21.2%) were treated with antibiotics during the acute infection [121 children aged 3–5 years (23.4%), 175 children aged 6–10 years (18.4%) and 31 adults (41.3%)]. Antibiotic treatment did not affect Salmonella excretion at any of the time points studied up to three months post‐infection in any age group as compared to age‐matched untreated controls. Persistent digestive symptoms were more common among the patients treated with antibiotics (9.5% vs. 2.9%; P=0.003).Conclusions: Antibiotic therapy does not affect Salmonella enteritis excretion. Digestive symptoms after clearance of the infectious agent are significantly higher in patients treated with antibiotics during acute gastroenteritis.