Chronic Salmonella bacteriuria with intermittent bacteremia treated with low doses of amoxicillin or ampicillin

Abstract

Amoxicillin and ampicillin were compared at a dose of 250 mg twice daily for 4 weeks to treat Salmonella typhi or Salmonella paratyphi A chronic bacteriuria with intermittent bacteremia. Eleven patients received amoxicillin, and 15 received ampicillin. Concentrations of the two drugs were measured in the urine and serum on treatment days 1, 2, and 7. The urine levels of both antibiotics were maximal 2 h after administration, and minimal levels were 80-fold higher than the S. typhi minimal inhibitory concentration and 20-fold higher than the S. paratyphi A minimal inhibitory concentration. The serum level of amoxicillin was below the minimal inhibitory concentration of S. paratyphi A 6 h after administration on each of the testing days. The serum antibiotic levels of the two drugs showed no cumulative effect at day 2 or day 7. Of the 11 patients treated with amoxicillin, 1 had positive urine cultures during treatment, and 1 treated with ampicillin continued to be symptomatic. Recurrence of bacteriuria occurred in three of seven patients with persistent bladder calcification. None of the 26 patients in this study had positive blood culture during or after treatment. Amoxicillin and ampicillin at a dose of 250 mg twice daily were equally successful in treating chronic salmonelluria.

Ceftiofur-Resistant Salmonella Strains Isolated from Dairy Farms Represent Multiple Widely Distributed Subtypes That Evolved by Independent Horizontal Gene Transfer

“…In the United States, Salmonella is the second most common identifiable cause of illness, and the leading cause of hospitalizations and deaths, due to food-borne bacterial infection (21). While most Salmonella infections result in temporary gastroenteritis that usually does not require treatment (23), invasive Salmonella infections generally require antimicrobial treatment (4,35). Traditionally, ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole were used to treat such severe cases, but the increasing number of antimicrobial-resistant Salmonella strains has led to a decrease in the efficacy of these treatments (2).…”

Salmonella Urinary Tract Infection and Bacteremia Following Non-Typhoidal Salmonella Gastroenteritis: An Unusual Presentation

“…Salmonella UTI has symptoms similar to other gram-negative UTIs, ranging from asymptomatic bacteriuria to renal abscess [ 8 ]. The reported duration of antibiotic therapy in a Salmonella urinary tract infection ranges from two (for mild infections) to over six weeks [ 9 ].…”

Nontyphoidal Salmonella Urinary Tract Infection in a Case of Hyperparathyroidism and Nephrocalcinosis

“…The reported duration of antibiotic therapy in Salmonella urinary tract infection ranges from two (for mild infections) to over six weeks (4,14). Longer duration of treatment was suggested by some experts, due to the high frequency of complicating conditions (18,19).…”

“…Longer duration of treatment was suggested by some experts, due to the high frequency of complicating conditions (18,19). However, prolong antibiotic therapy is of little benefit so long as the structural lesions remain (3,4,19).…”