Rx for Salmonella intestinal infection above the age of 50

Q: All males above the age of 50 should be treated with antibiotics for Salmonella intestinal infection regardless of the severity of the disease?

A) Yes

B) No

Answer: A

In salmonella infection of the gut, younger and older patients as well as patients who are in immunocompromised status such as HIV, past transplantation, to those who are on chronic steroid therapy should be treated pre-emptively with antibiotics, regardless of disease severity. Older patients, in particular with cardiac, valvular, endovascular, or joint diseases, are at high risk. This prompts antibiotic treatment in all patients over the age of 50. 

Beyonf age 50, almost 10% of patients with Salmonella intestinal infection develop arteritis as this organism has a high affinity for atherosclerotic endothelium.

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References:

1.Benenson S, Raveh D, Schlesinger Y, et al. The risk of vascular infection in adult patients with nontyphi Salmonella bacteremia. Am J Med 2001; 110:60.

2. Cohen PS, O'Brien TF, Schoenbaum SC, Medeiros AA. The risk of endothelial infection in adults with salmonella bacteremia. Ann Intern Med 1978; 89:931.