Efficacy of the combination pivampicillin/pivmecillinam compared to placebo in the treatment of convalescent carriers of nontyphi Salmonella.

In a randomized, double blind, placebo-controlled study 36 patients aged 16-77 years who had been carriers of nontyphi Salmonella species for 10-21 weeks were given the combination pivampicillin/pivmecillinam or placebo for four weeks in order to eradicate the carrier state. 34/36 patients who fulfilled the criteria for inclusion in the study were evaluable for efficacy, 16 in the pivampicillin/pivmecillinam group and 18 in the placebo group. Seven patients in the pivampicillin/pivmecillinam group had to terminate the treatment after 10-25 days because of adverse reactions, mainly exanthema and nausea. After therapy 8/16 patients treated with pivampicillin/pivmecillinam and 4/18 patients treated with placebo had negative stool cultures for Salmonella species during a mean follow-up time of 13 and 20 weeks, respectively. No abnormalities could be found in those patients who did not respond to therapy except for earlier cholecystectomy in two patients, both in the pivampicillin/pivmecillinam group.