![Sample our Medicine, Dentistry, Nursing & Allied Health journals, sign in here to start your FREE access for 14 days]({"type":"image" , "src" : "/sda/5944/TOC-Subject-Sample-2021-Medicine-Dentistry-Nursing-Allied-Health.jpg"})
Abstract
Since the introduction of sulfonamides in the late 1930s, selective pressure and the widespread dissemination of mobile genetic elements conferring antimicrobial resistance have forced clinicians to seek successive agents for the treatment of multidrug-resistant shigellosis. Over the decades, the principal antibiotics used to treat Shigella infections have included tetracycline, chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, and nalidixic acid. Presently, ciprofloxacin, azithromycin, and ceftriaxone serve as the mainstays of treatment, although growing evidence has documented decreased susceptibility or full resistance to these agents in some regions. With diminishing pharmaceutical options available, there is an enhanced need for preventive measures in the form of improved sanitation and hygiene standards, strict use of currently effective agents, and a safe and effective licensed vaccine.
Disclaimer
For the lead author, KC Klontz, the opinions and assertions contained herein are those of the author and are not to be construed as reflecting the views of the US FDA.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.
For patients with Shigella infections who have severe disease, bloody diarrhea or compromised immune systems, antibiotic treatment is recommended.
Since the introduction of sulfonamides in the late 1930s, selective pressure and the widespread dissemination of mobile genetic elements conferring antimicrobial resistance have forced clinicians to seek successive agents for the treatment of multidrug-resistant shigellosis.
Over the decades, the principal antibiotics used to treat Shigella infections have included tetracycline, chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole and nalidixic acid.
Currently, the mainstays of antimicrobial treatment of shigellosis include ciprofloxacin, azithromycin and ceftriaxone.
Mounting evidence documents decreased susceptibility or full resistance to ciprofloxacin, azithromycin and ceftriaxone in select regions of the globe.
The choice of antibiotics should be based on the results of susceptibility testing for the patient undergoing treatment, but when the severity of infection or risk of complications from infection dictate empirical therapy, the choice of agents should be guided by recent results of susceptibility testing for the geographic area where the patient likely acquired the infection.
Select population subgroups such as men who have sex with men have been identified as being at increased risk for developing shigellosis in general, and ciprofloxacin- or azithromycin-resistant shigellosis, in particular.
With diminishing pharmaceutical options available for the treatment of shigellosis, there is an enhanced need for preventive measures in the form of improved sanitation and hygiene standards, strict use of currently effective agents and a safe and effective licensed vaccine.