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
First-line options are azithromycin, ciprofloxacin, or ceftriaxone. (1) Clinical indications for empirical antibiotics include all cases of fever with bloody diarrhoea, bacillary dysentery, and abdominal cramping. (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% (3)
References:
- Center for Disease Control and Prevention. CDC Yellow Book 2024: health information for international travel. Section 5: travel-associated infections & diseases - shigellosis. Jun 2023 [internet publication].
- Shane AL, Mody RK, Crump JA, et al. 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea. Clin Infect Dis. 2017 Nov 29;65(12):e45-80.
- 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
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