Shigellosis
ICD-10 A03 · ICD-11 1A02
What Is the First-Line Treatment of Shigellosis?
Shigellosis is an acute bacterial intestinal infection. Prompt, appropriate antibiotic therapy is the cornerstone of management and is recommended by current WHO guidelines.
Treatment Approach
First-line management relies on antibiotic therapy; WHO guidelines identify a specific fluoroquinolone as the primary agent of choice. The full regimen — including agent selection, dosing, and duration — is set out in the complete protocol.
Treatment Goals
Effective therapy aims for clinical improvement within 48 hours, reduced risk of serious complications, shorter symptom duration, and elimination of Shigella from the stool.
References
DOI: 10.1080/20469047.2017.1409454
- Current guidelines for treating shigella were published by WHO in 2005 and they recommend ciprofloxacin as the first-line treatment (Table 1).
- Shigella Dysenteriae Type 1 listed the fluoroquinolone ciprofloxacin (15 mg/kg orally twice daily for 3 days) as first-line treatment for shigellosis in children, and (more expensive and less available) pivmecillinam (amdinocillin pivoxil) and (parenteral) ceftriaxone were listed as second-line therapy when local strains were known to be resistant to ciprofloxacin.
- With effective antibiotic therapy, clinical improvement occurs within 48 h, resulting in a decreased risk of serious complications and death, shorter duration of symptoms, and the elimination of shigella from the stool.