Treatment of chronic urinary salmonella carriers

Treatment of chronic urinary salmonella carriers with chloramphenicol at a dosage of 50 mg. per kg. body weight for 14 days was unsuccessful in 15 patients. All began to excrete salmonella again soon after completing treatment. All had active urinary schistosomiasis. A second group of 14 patients were treated with antimony tartrate or niridazole at a standard dose and 4 weeks of ampicillin at a dosage of 100 mg. per kg. body weight per day. 5 of these 14 patients relapsed but intravenous pyelography revealed that 3 of these 5 patients had advanced irreparably damaged urinary tracts and micturating cystograms showed that the other 2 had an established vesico-ureteric reflux. Though all 26 patients had a urinary carrier history of 12 months before treatment, all had positive blood cultures for the same organisms. It is suggested that chronic urinary salmonella carriers in Egypt be thoroughly examined and those with damaged urinary tracts due to schistosomiasis be given the benefit of anti-schistosomal treatment. Further studies are necessary to determine the exact place of prolonged chloramphenicol or ampicillin given alone or with anti-schistosomal treatment in the management of these patients.