Treatment of chronic salmonella carriers. Study with 40 cases of S. typhi, 19 cases of S. paratyphi b and 28 cases of S. enteritidis strains

Abstract

The present stage of our studies suggests that, provided a highly effective combined therapy is, and can be, carried out correctly, all excreters can be cured of their chronic carrier state by chemotherapy within 8-12 weeks. Although we cannot recommend a universal therapeutic regimen for all patients, a highly effective 'basic therapy' (RMP+TSP) is available for the majority of the cases, needing occasional modification, depending on the specific requirements of the individual patient as shown by the result of the serum activity determination. This method saves the patient from toxic inconveniences caused by inadequate treatment, it shortens the treatment time and makes cholecystectomy superfluous - unless it is considered necessary out of a different indication in which case it should certainly be done. We cannot share the often expressed view that Salmonella enteritidis excreters cannot be cured, a view which is found even in the most recent manuals. The same applies to the view that therapy is not necessary because it would delay cure. It is indispensable to establish a close cooperation between the public health authorities and the private physician, and we therefore wish to sincerely thank all colleagues and Public Health Officers for their collaboration.