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  • Title: [Rational therapy of salmonella enteritis].
    Author: Hof H, Kretschmar M.
    Journal: Leber Magen Darm; 1994 Mar; 24(2):57-8, 61-4. PubMed ID: 8196466.
    Abstract:
    One prerequisite for an effective treatment of a salmonella enteritis with antibiotics is a reliable direct antibacterial activity of the drug. In comparison to most of all other usual antibiotics quinolones, especially ciprofloxacin, fulfill these conditions, because its activity is high and resistance of Salmonella against quinolones is extremely rare. Since quinolone resistance is never plasmid coded, there will be even in the future no obvious risk of spreading of resistant strains. Another prerequisite is that the drug is able to have access to the site of residence of the microorganism. Salmonella spp. possess the virtue to penetrate into host cells and to reside and even to multiply there. Curing can be achieved only when these intracellular bacteria are eradicated. Elimination of Salmonella in the gut lumen alone is not satisfactory. Only few antibiotics are taken up into host cells, which could explain the rather frequent failure rate of antibiotic therapy of salmonella enteritis. Quinolones on the other hand are accumulated in host cells and in addition are able to act upon bacteria in this peculiar intracellular environment. Among the various quinolone derivatives ciprofloxacin is particularly qualified because it is excreted via the intestine to a considerable extent, so that high concentrations may be achieved at the proper site. The clinical experience demonstrates indeed that in most instances a rapid amelioration of the acute disease is achieved and in chronic carriers a high rate of curing occurs. Thus, for microbiological, pharmacological, and clinical reasons one can recommend ciprofloxacin for the treatment of enteric infections with Salmonella spp.
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