Treatment of shigellosis

Mild form of the disease is usually self-limiting and no treatment is necessary. However, it is important to maintain fluid balance with clear oral fluids, or in more severe cases intravenous infusion.

• seek expert microbiology advice
• antibiotic treatment is not required for all cases of shigellosis
• cases with prolonged symptoms or complications may require antibiotics
  • commonly used antibiotics include macrolides, fluoroquinolones, aminoglycosides, sulphonamides, trimethoprim, tetracycline, and third-generation cephalosporins (1,2)
  • in the UK, note that the among GBMSM, the proportion of all Shigella spp. isolates that are multi-drug resistant, or XDR (extensively drug resistant) is very high, often exceeding 90% (2)

A review suggests (3):

The severely ill or those at the extremes of life may be given antibiotic treatment

• preferred therapy – azithromycin, ceftriaxone
• alternative agents - ciprofloxacin, cefixime (3)

Reference:

• PHE (2019). Recommendations for the Public Health Management of Gastrointestinal Infections
• Charles H et al. Spotlight on drug-resistant Shigella: raising awareness within general practice. BJGP 2023; 73 (729): 187-188. DOI: https://doi.org/10.3399/bjgp23X732537
• Bruzzese E, Giannattasio A, Guarino A. Antibiotic treatment of acute gastroenteritis in children. F1000Research. 2018;7:193.