Salmonellosis treatment

In the case of mild and moderate forms of salmonellosis with exsicosis:

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

To children of early age it is expedient from the first days of illness to appoint:

• bacterial preparations (acipol, bifystim, bifidumbacterin 10-20 doses / day, lactobacterin, linex, enterol, etc.);
• prebiotics (lactofiltrum);
• or include in food bifidokefir (bifid) for 200-400 ml / day fractional.

In addition, prescribe vitamins and indications for antihistamines (chloropyramine (suprastin), promethazine, etc.].

With "watery diarrhea" with a frequency of stool more than 3-5 times the purpose of the antidiarrheal drug loperamide (imodium) is shown. Parenteral administration of cycloferon in a dose of 10-15 mg / kg of body weight is also shown.

At the expressed painful syndrome prescribe spasmolytic (no-shpa, papaverine, etc.), with frequent vomiting and regurgitation - fractional food, gastric lavage, from medicamentous agents are shown metoclopramide (cerukal, raglan), KKBidr.

In severe forms of salmonellosis, especially in severe toxicosis (grade II-III), infusion therapy is performed for the purpose of detoxification (1.5% reamberin solution) and rehydration, as well as posidrome therapy (anticonvulsant, hypothermic, etc.). It is important to distinguish the leading syndrome, which determines the severity of the patient's condition (neurotoxicosis, toxicosis with exsicosis, endotoxin or infectious-toxic shock).

The appointment of antibiotics is indicated for severe and generalized forms of salmonella, regardless of the child's age, as well as to all children of the first year of life with a burdened premorbid background and with mixed infection. In these cases, antibiotics are administered parenterally (or parenteral administration is combined with enteral). Drugs of choice for salmonellosis consider amikacin, rifampicin, nevi-gramon. It is important to consider the susceptibility to antibiotics of the salmonella strains circulating in the area. Simultaneously with antibiotics, it is necessary to prescribe probiotic drugs (acipol, etc.).

Antibiotic therapy is not recommended for children with light, erased forms of salmonella, as well as patients entering the hospital during the convalescence (only with abnormal stools or repeated bacterial excretion). In these cases, it can be limited to the appointment of a rational diet, enzyme preparations (mikrazim), bifidumbacterin, stimulating therapy (pentoxyl, methyluracil, etc.), bacteriophage of salmonella, symptomatic therapy, and immunoglobulin complex preparation (CIP) 5-7-day course.

The means of specific etiotropic therapy of salmonellosis is the bacteriophage salmonella and KIP (containing elevated antibody titres and to salmonella).

In order to prevent a prolonged course of the infectious process, it is advisable to include the preparation Cycloferon in the complex therapy of intestinal infections. The drug activates the cellular immune response, enhancing the production of specific immunoglobulins class A, nonspecific immunoglobulins of class M. Clinical effect of cycloferon is in the smooth course of the disease, the absence of repeated excretion of the pathogen.

In 12.8% of patients receiving antibacterial therapy, repeated excretion continued. Among patients with yersinioznoy infection, who received in the acute period of the disease tsikloferon, there was a tendency to a rare development of relapses of the disease (9% vs. 16%). In patients with dysentery and salmonellosis who received cycloferon in complex therapy, microbiological sanation occurs in 90.3% of patients, in 89% of patients normalizes the stool. The expediency of cycloferon in the complex correction of intestinal dysbiosis in children of early age is shown (the level of intestinal microflora was restored to normal in 95% of patients, and the number of opportunistic microflora was reduced by 12 times).