infectious diseases
Shigellosis
Treatment of Shigellosis
Supportive care For severely ill or at-risk patients, a fluoroquinolone,azithromycin, or a 3rd-generation cephalosporin Fluid loss due to shigellosis is treated symptomatically with oral or Intravenous Fluid Resuscitation . Antidiarrheal drugs (eg,loperamide) may prolong illness and should not be used. Antibiotics can reduce the symptoms and shedding ofShigellabut are not necessary for healthy adults with mild illness. However, certain patients, including the following, should usually be treated: Children Older people Debilitated patients Patients with moderate to severe disease For adults, the following antibiotic regimens may be used: A fluoroquinolone (such asciprofloxacin500 mg orally every 12 hours for 3 to 5 days) Azithromycin500 mg orally on day 1 and 250 mg once a day for 4 days Ceftriaxone2 g/day IV for 5 days For children, the following antibiotic regimens may be used: Ceftriaxone50 mg/kg (maximum 1.5 g) IV once a day for 5 days Azithromycin10 to 12 mg/kg orally as a single dose on day 1, followed by 6 mg/kg (maximum 250 mg) once a day for 4 days ManyShigellaisolates are likely to be resistant toampicillin,trimethoprim/sulfamethoxazole (TMP/SMX), and tetracyclines, but patterns of resistance vary by geographic region. 