Salmonellosis treatment is a complex of therapeutic measures aimed at combating the causative agent of the disease and its clinical symptoms, which are carried out in accordance with the developed therapeutic scheme. The causative agent of salmonellosis is bacteria of the genus Salmonella, the most common of which is Salmonella enteritidis group D.
This infectious disease is a real threat for adults with weakened immune systems. For the elderly and children, including salmonellosis, it is extremely contagious, so most of the affected ones are treated in hospitals of infectious medical institutions.
The main signs of infection with salmonellosis are consistent with the symptoms of poisoning and intoxication - the person has a fever, nausea and vomiting, after a while there is pain in the abdomen and diarrhea.
Medications for salmonellosis
Drug therapy is the basis of the treatment of infection. The patient will have to take several groups of drugs, which include antibacterial drugs as etiotropic treatment, rehydration drugs, detoxifying drugs, sorbents, anti-diarrheal drugs, antispasmodics and enzyme preparations.
Etiotropic treatment of salmonellosis is necessary for moderate and severe forms, as well as for generalized. Antibiotics of the cephalosporin group, fluoroquinolones and antimicrobial agents of the nitrofuran group, as well as salmonella bacteriophage, are drugs of choice.
Rehydration therapy is carried out by ingesting electrolyte solutions as a drink (rehydron, glucosolan), and in severe cases, therapy is supplemented with parenteral administration of saline solutions and glucose solutions.
In the treatment of dehydration, detoxification therapy is also prescribed - glucose is administered intravenously to the patient, Rheopoliglukin.
Together with the intake of antibiotics, it is important to introduce into the treatment regimen funds that restore the intestinal flora, as it suffers from both salmonella and etiotropic drugs. Assigned to the use of probiotics - Linex, Hilak forte, Baktusubtila.
The sorbents traditionally used in the treatment of salmonellosis are activated carbon, Atoxil, Enterosgel, Neosmectin.
For enzymatic support of the digestive tract, Pancreatin, Mezim Forte or Creon is prescribed.
It is not always advisable to prescribe antidiarrheal drugs, because if diarrhea is not very intense, its frequency does not exceed 4-5 bowel movements per day, and the total percentage of fluid loss is no more than 2-3% of the patient’s body weight, it is better not to interrupt bowel cleansing process. It is in the intestines that the most active process of reproduction of salmonella occurs, and without appropriate indications it is better not to interfere with their natural removal.
In the presence of spastic pains in the intestines, especially during bowel movements, antispasmodics are used - Papaverine, No-spa, Spasmalgon.
|Drug name||Pharmaceutical Group||Drug action|
|Ceftriaxone||Antibacterial drugs, other beta-lactam antibiotics||Intravenous or intramuscular administration is recommended. The course is from 7 to 14 days.|
Ceftriaxone is a third-generation cephalosporin antibiotic. It has a bactericidal action, carried out by inhibiting the synthesis of bacterial cell walls. The tool is active against a wide range of gram-positive and literal cocci, including against salmonella.
|Ciprofloxacin||Antibacterial agents for system use, fluoroquinolones||Assigned for oral administration.|
Ciprofloxacin is an antimicrobial drug that affects the DNA gyrase of bacteria and the process of reproduction of bacterial DNA. It has a bactericidal effect on microorganisms at rest and reproduction.
|Trisol||Solutions for the correction of violations of water and electrolyte balance||Salt plasma replacement solution has a detoxification effect, prevents blood clots, reduces hypovolemia, improves microcirculation, increases diuresis.|
|Regidron||Electrolyte preparations with carbohydrates. Salt formulations for oral rehydration||The tool accelerates the restoration of the level of potassium, sodium and other trace elements that are washed out from the body during diarrhea and vomiting.|
|Linex||Antidiarrheal microbial agents||Lactic acid bacteria in the composition have a local effect in the digestive tract, fighting with intestinal dysbiosis. The drug is intended for the treatment of diarrhea and the effects of antibiotics.|
|Atoxyl||Enterosorbents||It has a sorption, antimicrobial, detoxification effect, absorbs toxins and allergens from the digestive tract. It promotes the transfer of toxic elements from the blood and lymph, and their further removal from the body.|
|Neosmectin||Antidiarrheal drugs, enterosorbents||It has an absorbing effect, stabilizes the mucous barrier, increasing the amount of mucus and improving its gastroprotective properties against hydrochloric acid and bile. It has no direct effect on intestinal motility.|
|Pancreatin||Multienzyme preparations to improve digestion||The drug improves and facilitates the process of digestion of proteins, carbohydrates and fats, helps to enhance the absorption of nutrients in the small intestine.|
Dissolution occurs in the duodenum, the substance acts in the intestinal lumen.
|Enterofuril||Antimicrobial drugs for the treatment of intestinal infections||The active ingredient nifuroxazide - an antimicrobial agent, intestinal antiseptic. It blocks the activity of dehydrogenases, inhibits the processes of cellular respiration and protein synthesis in microbial cells. Reduces toxin production.|
|Papaverine||The drug used in functional digestive disorders||The active ingredient relieves spasms of smooth muscles of the abdominal cavity, urinary tract, and renal colic.|
Diet during treatment
Medical nutrition for salmonellosis is a mandatory requirement that must be observed in the presence of symptoms of damage to the digestive tract - diarrhea, pain, nausea. All food that enters the body, should be the most gentle effect on the intestinal mucosa and stomach. For this disease, Pevzner's diet No. 4 is suitable, the essence of which is to provide the body with essential nutrients, without causing stress on the intestines and not allowing it to ferment processes. Dietary nutrition according to the rules of table number 4 is prescribed to the patient from the first day of treatment, and later, after his recovery, he needs to stick to table number 13 for 2-4 weeks.
All dishes are steamed or boiled, mastered or milled to a liquid and semi-liquid state. Meals are built on the principle of fragmentation, should be 4-5 meals in small portions. In addition, be sure to drink 2-3 liters of fluid per day.
These foods are excluded from the diet:
- smoked foods, seasonings, pickled meals and snacks;
- fatty meat, fish, sausages and canned foods;
- any pastry, confectionery, sugar, honey, chocolate;
- fresh bread, especially dark;
- grapes, plums, pears, citrus;
- vegetables with a rough texture: radish, legumes, radishes, cucumbers, cabbage of any variety;
- whole milk in any form;
- fatty food;
- cereals, heavy for digestion: corn, millet, barley, barley;
- coffee, cocoa, carbonated sugary drinks, alcohol.
It is necessary to place emphasis in the menu on food, which requires minimal effort from the digestive tract for digestion, as well as on products that reduce inflammation.
When salmonellosis is allowed to use:
- apples and bananas, baked apples;
- potatoes, carrots in boiled form, cooked as mashed potatoes;
- blueberries, cranberries, which strengthen the immune system;
- low-fat varieties of fish and meat in the form of steam meatballs and meatballs;
- white crackers;
- light chicken broth, vegetable and slimy soups;
- semolina, rice, buckwheat.
You can drink non-carbonated mineral water, green tea, jelly and fruit compotes.
Recipes of traditional medicine for salmonellosis can be used only in consultation with your doctor. Salmonella infection is a serious disease that, if you choose the wrong methods, can be fatal. Therefore, conventional medical treatment should be the basis of treatment, and in addition to etiotropic treatment, to alleviate some of the symptoms and manifestations of infection, you can apply traditional treatment.
Calendula and chamomile are long-known anti-inflammatory agents for the mucous membrane of internal organs. Infusion of calendula flowers has a disinfectant, cleansing and anti-inflammatory effect. It is prepared as follows: a teaspoon of dry raw materials is brewed in a glass of boiling water, and half a glass of the infusion is drunk 2 times a day.
Chamomile medicinal brewed with water at the rate of a tablespoon of flowers in a glass of water. The broth is boiled for 5 minutes, then, removing from the heat, leave to infuse for 4 hours. After the broth is filtered through a double layer of gauze, drink 4 times a day, 2 tablespoons after meals.
Plantain - a medicinal plant that has exceptional healing properties. The infusion of plantain is made from dried crushed leaves. On a glass of boiling water add a tablespoon of raw materials, leave the glass closed for 10 minutes. The infusion is drunk after it cools down, in small sips, up to 3 times a day.
In the treatment of salmonellosis also use bird cherry and strawberry. The fruits of the bird cherry are added to a glass of boiling water, put on a steam bath for 20 minutes, then the medicine is removed from the bath, cooled and filtered. Half a glass is drunk half an hour before meals.
A decoction of strawberries is prepared in the following way: fresh leaves of the plant are poured with cold boiled water for 6-9 hours. Ready medicine tsedyat. On the day you can take up to 2 glasses of funds, half a glass before meals.
How are treated in the hospital
Salmonellosis treatment occurs in the infectious disease ward.
First of all, after hospitalization, the attending physician assesses the patient's condition and decides whether a gastric lavage procedure is necessary. This is relevant only at the very beginning of the disease, at the onset of the first symptoms, to remove food debris from Salmonella infected from the digestive tract.
Gastric lavage is performed using a rubber catheter and an Esmarch cup.
For washing it is necessary to prepare 2-3 liters of soda solution at a concentration of 2%, with a temperature of 18-20 degrees.
They wear a rubber apron on the patient, seat him or lay him on his side. The rounded end of the tip of the tube is smeared with vaseline and injected onto the root of the tongue. The patient needs to swallow movement to push the tip with a rubber tube (probe) into the esophagus. When the probe is inserted into the stomach, its contents must be removed through a tube - a glass funnel is put on the probe, it falls below the level of the stomach, and 500 ml of liquid is poured into it for washing. Then the funnel is raised above the level of the stomach, and the washings along with the contents of the stomach are washed into the basin. The procedure is repeated until the washings are clean.
Next, the patient is directed to the delivery of blood tests, bakposev, ultrasound of the abdominal cavity. According to the results, he is prescribed treatment, develop a regimen of medication. Even before receiving the test results, in the first 2-4 hours of the patient's stay in the hospital, it is necessary to begin the introduction of rehydration preparations, solutions (intravenously drip or oral) to ensure the replenishment of the lost fluid and salts, normalize the water-salt balance, remove toxins from the body. Regidron, Oralit, Glukosolan is administered orally, Trisol, Gemodez, Acesol, Chlosol, Quartasol are administered intravenously.
To normalize the digestive process, it is necessary to introduce into the treatment regimen enzyme preparations such as Festala, Holensim, Mezim forte, Pancreatin. In addition, you need to use tools that bind and remove toxins from the body: Smektu, Enterosgel, Enterodez.
The expediency of prescribing antibiotics in each particular case of treatment is decided by the attending physician. It is believed that if the disease does not have a generalized form, antibiotics can not be used, since the body is able to cope with the pathogen on its own. If the pathogen passes from the digestive tract to other organs and tissues, the patient is prescribed the drugs listed above antibacterial and antimicrobial groups.
How to fight at home
It should be noted that even if the course of the disease can be characterized as a lung, the sick should definitely see a doctor, get tested, get treatment recommendations. Self-treatment at home is unacceptable, as it can cause a person's death from dehydration, or infectious toxic shock. Especially carefully you need to treat the independent use of antibiotics for children and people with a weakened body.
Usually the disease develops rapidly. The incubation period lasts an average of 12-24 hours, after which the state of health significantly deteriorates - first the temperature rises, nausea and vomiting appear, followed by diarrhea and dehydration. What to do in such cases before the arrival of the ambulance?
First of all, if the patient has vomiting, it is better not to try to stop it - so the body tries to get rid of salmonella and toxins.
It is important to start taking sorbents as soon as vomiting is over. To this end, give the patient Atoxil, activated carbon, Enterosgel. The lost liquid must be filled with a drink of a solution of Regidron or green tea, non-carbonated mineral water, decoctions of medicinal herbs. You need to drink at least 1 liter of liquid in an hour and a half, depending on the volume of excrement, often in small portions.
Until a patient is examined by a doctor and the onset of the first improvement, no food should be given to the child or adult. Young children are given only clean water.
Even if after a few hours the patient has some improvement, you can not stay at home - you must always consult a doctor to determine the cause of the disease and assess the severity of the patient's condition.
Recovery from dehydration
The fight against dehydration is carried out in order to serious metabolic processes in the organs and tissues of the body. The treatment is carried out by taking salt solutions and mineral waters. At the pharmacy, you can buy Regidron, Citroglukosolan or Oralit, as well as mineral table medicinal waters (you can only drink them after the gas is completely out of them).
You can prepare a solution at home - 20 g of glucose and 1.5 sodium chloride are taken per liter of water.
Compote and kissel brewed from dried apricots, raisins, blueberries, rose hips, and cranberries can be given to children over 3 years old and adults.In the finished compote, be sure to add half a teaspoon of soda and salt to replenish lost reserves of minerals. Three sips of the drink should be drunk every 5 minutes, gradually increasing the volume of liquid. Sugar and honey in the drinks is not recommended.
Features of treatment in children
In fact, the treatment of children with salmonellosis is based on the same principles as therapy for adults.
First of all, the child must be shown to the doctor. Before this happens, provide bed rest and a constant replenishment of the fluid lost with salt solutions, mineral water, tea, compotes.
It is better not to eat, although the baby himself is unlikely to complain of hunger. In the presence of high temperature, it is permitted to give Panadol or another antipyretic agent before the arrival of the doctor.
It will be quite difficult to feed the baby in the state of acute salmonellosis, therefore it is necessary to call an ambulance at the first signs of the disease, and before the arrival of the physicians it is more often to apply to the chest or add boiled water.
Further, after the examination, a scheme of drug treatment is being developed, which, like in adults, includes the administration of antibiotics, adsorbents, antidiarrheal drugs, enzyme and antimicrobial agents.
Depending on what the current takes the disease, the duration of treatment has different terms. So, for example, the rarely occurring localized gastritic form passes quickly - that is, literally in 2-4 days, the patient begins to feel better. Gastroenterocolitic and gastroenteric variants of the disease are treated longer - usually the recovery period is at least a week.
As for the generalized forms, namely typhoid and septic, the duration of treatment in each case is different, but doctors say at least 3 weeks before the moment when the patient can be called recovered. We should not forget about the recovery time after the disease - it ranges from 2-3 weeks to several months.
Septic salmonellosis, which tends to become chronic, is treated the longest. In this case, we can talk about 3 months of treatment and more.
Can salmonellosis pass without treatment
The question of whether the infection can pass by itself, without medical intervention, confuses any doctor. If we talk about the symptoms of the disease, if it occurs in a mild form, and the body of the diseased is strong enough, its immunity works fine, for example, you can do without taking antimicrobial agents and antibiotics. However, without replenishing and correcting the water-salt balance, without removing toxins and medicamentally normalizing the intestinal flora, the condition of a person after salmonellosis can hardly be called recovery. Mild forms of infection can turn into a generalized course, into a chronic form, cause dangerous and even incompatible with life consequences. And even if the pathogen itself dies without treatment, it will be extremely difficult for the human body to recover on its own. In addition, it is not known exactly how the transferred infection will affect the cardiovascular, nervous and digestive systems in the future.
As for the moderate and severe forms, without treatment they can only lead to complications, toxic shock, dehydration, coma, but not to the patient's recovery.
Despite the fact that the mortality rate among patients with salmonellosis is not the highest, you should not hope for a favorable outcome without the intervention of physicians, and it is better to immediately seek help.
Who to contact with salmonellosis? Usually, if the victim has a severe deterioration in health, and he is called an ambulance, the team takes the patient to an infectious diseases hospital. Infectionsists take part in the treatment in the hospital, if necessary, a gastroenterologist, pediatrician, allergist.
When self-referring to a doctor, first of all, the patient will be referred to a general practitioner or family doctor for a general examination, and he will already transfer the patient to an infectious diseases specialist and a gastroenterologist.
For the treatment of salmonellosis of any form should seek medical help from a doctor for diagnosis, assess the severity of the patient's condition and the appointment of adequate treatment. Therapy against Salmonella infection is complex in nature, and includes drugs that act directly on the pathogen, as well as restoring and compensating means, therapeutic gentle food for the patient.
Specialty: therapist, nephrologist.
Total experience: 18 years.
Place of work: Novorossiysk, medical center "Nefros".
Education: 1994-2000 Stavropol State Medical Academy.
- 2014 - "Therapy" full-time advanced training courses on the basis of the State Budgetary Medical Educational Institution of Higher Professional Training "Kuban State Medical University".
- 2014 - "Nephrology" full-time refresher courses on the basis of the Stavropol State Medical University.