Salmonellosis treatment

For mild and moderate forms of salmonellosis with exsicosis, the following are indicated:

• oral rehydration with glucose-salt solutions: rehydron, glucosolan, etc.;
• enterosorbents: filtrum-STI;
• enzyme preparations taking into account the topic of the gastrointestinal tract lesion: abomin, festal, pancreatin (micrazyme, creon), panzinorm, etc.

For young children, it is advisable to prescribe the following from the first days of illness:

• bacterial preparations (Acipol, Bifistim, Bifidumbacterin 10-20 doses/day, Lactobacterin, Linex, Enterol, etc.);
• prebiotics (lactofiltrum);
• or include bifidokefir (bifidok) in your diet, 200-400 ml/day, in small portions.

In addition, vitamins and, if indicated, antihistamines [chloropyramine (suprastin), promethazine, etc.] are prescribed.

In case of "watery diarrhea" with a stool frequency of more than 3-5 times, the antidiarrheal drug loperamide (Imodium) is indicated. Parenteral administration of cycloferon at a dose of 10-15 mg/kg of body weight is also indicated.

In case of severe pain syndrome, antispasmodics are prescribed (no-shpa, papaverine, etc.); in case of frequent vomiting and regurgitation - fractional meals, gastric lavage; metoclopramide (cerucal, reglan), KKBidr are indicated as medications.

In severe forms of salmonellosis, especially with severe toxicosis (grades II-III), infusion therapy is administered for the purpose of detoxification (1.5% reamberin solution) and rehydration, syndrome-based therapy (anticonvulsant, hypothermic, etc.). It is important to identify the leading syndrome that determines the severity of the patient's condition (neurotoxicosis, toxicosis with exsicosis, endotoxin or infectious-toxic shock).

Antibiotics are indicated for severe and generalized forms of salmonellosis regardless of the child's age, as well as for all children in their first year of life with a complicated premorbid background and mixed infections. In these cases, antibiotics are administered parenterally (or parenteral administration is combined with enteral administration). The drugs of choice for salmonellosis are amikacin, rifampicin, and nevigramon. It is important to consider the sensitivity of salmonella strains circulating in a given area to antibiotics. Probiotic preparations (Acipol, etc.) should be prescribed simultaneously with antibiotics.

Antibiotic therapy is not recommended for children with mild, latent forms of salmonellosis, as well as for patients admitted to hospital during the convalescence period (only with abnormal stool or repeated bacterial excretion). In these cases, it is possible to limit oneself to prescribing a rational diet, enzyme preparations (micrazyme), bifidumbacterin, stimulating therapy (pentoxyl, methyluracil, etc.), salmonella bacteriophage, symptomatic therapy, and an immunoglobulin complex preparation (ICP) for a 5-7-day course.

The means of specific etiotropic therapy for salmonellosis are salmonella bacteriophage and KIP (containing increased titers of antibodies to salmonella).

In order to prevent a protracted course of the infectious process, it is advisable to include cycloferon in the complex therapy of intestinal infections. The drug activates the cellular immune response, enhancing the production of specific immunoglobulins of class A, non-specific immunoglobulins of class M. The clinical effect of cycloferon is a smooth course of the disease, the absence of repeated release of the pathogen.

In 12.8% of patients receiving antibacterial therapy, repeated isolation of the pathogen continued. Among patients with yersiniosis infection who received cycloferon in the acute period of the disease, a tendency to rare development of relapses of the disease was noted (9% versus 16%). In patients with dysentery and salmonellosis who received cycloferon in combination therapy, microbiological sanitation occurs in 90.3% of patients, in 89% of patients the stool is normalized. The expediency of using cycloferon in the complex correction of intestinal dysbiosis in young children has been shown (the level of intestinal microflora was restored to normal in 95% of patients, and the number of opportunistic microflora decreased by 12 times).