The Role of Short-course Ceftriaxone Therapy in the Treatment of Severe Nontyphoidal Salmonella Enterocolitis
The Role of Short-course Ceftriaxone Therapy in the Treatment of Severe Nontyphoidal Salmonella Enterocolitis
The purpose of the investigators study is to evaluate if short-course of ceftriaxone therapy
 could shorten the clinical courses of severe nontyphoidal Salmonella enterocolitis in
 children and the excretion of Salmonella in feces.
Nontyphoidal salmonellae (NTS) is one of the most important pathogens of gastroenteritis in
 humans. Although most nontyphoidal Salmonella infections result in self-limited
 gastroenteritis, invasive infections such as bacteremia, meningitis or extraintestinal
 infection could also occur. Antimicrobial therapy is not recommended for routine treatment of
 nontyphoidal salmonellosis and effective antibiotic treatment is essential if NTS infection
 spreads beyond the intestine such as bacteremia, meningitis or osteomyelitis.

 Although some reports revealed that antimicrobial therapy may be beneficial for shortening
 the clinical courses of severe NTS enterocolitis, most of them were based on clinical
 observations, not based on the results of objective examinations. Thus, the use of
 antibiotics in the treatment of patients with severe NTS gastroenteritis is still
 controversial in clinical practice.

 As a third generation cephalosporin, ceftriaxone has a higher concentration than conventional
 antibiotics such as ampicillin and trimethoprim-sulfamethoxazole in the intestinal mucosa and
 gallbladder. Besides, ceftriaxone maintains relatively lower resistance rate in Salmonella
 than those of other conventional antibiotics. So the purpose of our study is to evaluate if
 short-course of ceftriaxone therapy could shorten the clinical courses of severe NTS
 enterocolitis in children and the excretion of Salmonella in feces. The investigators think
 that the study may be helpful for clinicians in the treatment of severe NTS enterocolitis in
 children, especially on the judgments of the choices and the treatment cures of antibiotics.
Inclusion Criteria:

 -  Children with suspected severe Salmonella enterocolitis

 -  defined as those with a high fever (core body temperature ≥ 38.5℃) persisting for
 longer than 48 hours

 -  diarrhea with mucous and bloody-tinged stool.

 Exclusion Criteria:

 -  Children with a toxic appearance, severe vomiting and abdominal distension

 -  suggestive of sepsis or toxic megacolon, those with an increased risk of invasive NTS
 diseases

 -  immunosuppressive illnesses

 -  had taken antibiotics during the 7 days before the visit will be excluded.