Treatment of Nontyphoidal Salmonellosis in Infants Under 6 Months of Age
In infants under 6 months of age, nontyphoidal Salmonella (NTS) infection carries a heightened risk of invasive disease and serious complications. When Salmonella is detected in stool with no evidence of bacteraemia, the approach in this very young age group follows specific considerations that differ from older children.
Clinical Scenario
Infant aged under 6 months with Salmonella identified in stool and no Salmonella bacteraemia confirmed. Evidence to guide management in this specific population is very limited; however, the risk of extra-intestinal dissemination in young infants is the key clinical consideration.
Treatment Approach
Antibiotic treatment is recommended for all infants in this age group. The route of therapy — oral or intravenous — is determined by the infant's clinical status at presentation, with assessment for fever and signs of systemic illness guiding the initial choice.
References
- Salmonella in stool; no bacteremia
- There is very limited evidence to guide treatment recommendations for NTS gastroenteritis in young infants (less than six (6) months of age).
- 7 days antibiotic treatment (oral switch if child well)
- If febrile or unwell, take blood culture +/- CSF and commence IV antibiotic
- Due to the increased risk for invasive disease and severe sequelae of invasive infection, we recommend treating all infants in this age group although risk of extra-intestinal dissemination needs to be balanced against the well-established risk of prolonged excretion.