A Warning Against Antibiotic Treatment for Gastrointestinal Non-Typhoidal Salmonella Infections in Immunocompetent Adults: A Case Report and Review of the Literature

<i>Salmonella enterica</i> is a common pathogen that causes foodborne illness worldwide. There is limited evidence describing the treatment of gastrointestinal non-typhoidal <i>Salmonella</i> (NTS). Clinicians are inclined to treat these infections with antibiotics, but the use of antibiotics may paradoxically worsen gastrointestinal symptoms and prolong bacterial stool shedding. This is a case of gastrointestinal NTS in 30-year-old immunocompetent female patient. She experienced prolonged diarrhea for six weeks following food poisoning with <i>Salmonella enterica</i> Serovar Enteritidis and received antibiotics as a treatment for her symptoms. The antibiotics worsened her symptoms, and she continued to have positive stool tests. At week 11 following the initial infection, she was advised by her infectious diseases physician to avoid further antibiotic use and take probiotics including <i>Saccharomyces boulardii</i> and kefir probiotics. These improved her gastrointestinal symptoms; however, she continued to have bacterial stool shedding for a total of 25 weeks. Antibiotics should be avoided for the treatment of gastrointestinal NTS in immunocompetent adults due to their lack of benefit and their potential for worsening and/or prolonging symptoms. Treatment should instead focus on recovering the gut microbiome.