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Azithromycin for Salmonella infection: don’t presume it works

Alan J Rogers, Gar-hing A Lee and Peter Boan
Med J Aust 2018; 209 (2): . || doi: 10.5694/mja18.00372
Published online: 16 July 2018

Salmonella infection manifests as enteritis and enteric fever, predominantly acquired overseas. When required, therapy with azithromycin, ciprofloxacin or ceftriaxone is recommended by the Therapeutic guidelines: antibiotic;1 however, reduced susceptibility to fluoroquinolones in Asia limits the use of ciprofloxacin unless susceptibility is confirmed.2 The Australian Bureau of Statistics recorded a 546% increase in short term departures to Indonesia over 10 years, with 1.2 million nationally in 2016.3


  • 1 PathWest Laboratory Medicine WA, Perth, WA
  • 2 Royal Perth Hospital, Perth, WA
  • 3 Fiona Stanley Hospital, Perth, WA



Competing interests:

No relevant disclosures.

  • 1. Antibiotic Expert Groups. Therapeutic guidelines: antibiotic. Version 15. Melbourne: Therapeutic Guidelines Limited, 2014.
  • 2. Crump JA, Sjölung-Karlsson M, Gordon MA, Parry CM. Epidemiology, clinical presentation, laboratory diagnosis, antimicrobial resistance, and antimicrobial management of invasive Salmonella infections. Clin Microbiol Rev 2015; 28: 901-937.
  • 3. Australian Bureau of Statistics. 3401.0 – Overseas Arrivals and Departures, Australia, Dec 2016. http://www.abs.gov.au/ausstats/abs@.nsf/products/961B6B53B87C130ACA2574030010BD05 (viewed Mar 2018).
  • 4. Sjölung-Karlsson M, Joyce K, Blickenstaf K, et al. Antimicrobial susceptibility to azithromycin among Salmonella enterica isolates from the United States. Antimicrob Agents Chemother 2011; 655: 3985-3989.
  • 5. Hassing R-J, Goessens WHF, van Pelt W, et al. Salmonella subtypes with increased MICs for azithromycin in travellers returned to the Netherlands. Emerg Inf Dis 2014; 20: 705-708.

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