Shigellosis Treatment & Management

Updated: Jun 17, 2019
  • Author: Joyann A Kroser, MD, FACP, FACG, AGAF; Chief Editor: BS Anand, MD  more...
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Treatment

Medical Care

General supportive care of patients with shigellosis includes the following: [36]

  • High fever in children should be treated.

  • Narcotic-related antidiarrheals should be avoided.

  • Antibiotic treatment is indicated in most patients. [37]  Note that antibiotic-resistant Shigella species have emerged [15] ; thus, obtaining susceptibility testing and monitoring local shigellosis outbreaks is crucial.

  • Clear liquids followed by a low-residue, lactose-free diet are recommended until symptoms of shigellosis resolve.

Antimotility agents should be avoided. They have the potential to worsen symptoms and may predispose to toxic dilation of the colon.

For fluid and electrolyte supplementation, oral rehydration solutions are preferable.

Consultations

Consult a gastroenterologist or an infectious diseases expert if the Shigella infection is prolonged or if the patient experiences a severe course of shigellosis that is unresponsive to antibiotics.

Patient education

Educate patients about proper hygiene. Careful handwashing and stool precautions should prevent the dissemination of shigellosis. Thus, primary preventive measures should include universal availability of potable water, provision of sanitation methods, and improved personal and food hygiene. [2]

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Prevention

A vaccine for shigellosis is not currently available. Until a vaccine is available, the following measures can help prevent the dissemination of shigellosis:

  • Use of safe drinking water

  • Chlorination of unreliable water sources

  • Strict handwashing

  • Refrigeration and proper preparation and cooking of food. Food handlers must be treated with antibiotics and should not be involved in food preparation as long as stool cultures are positive for Shigella infection. At least 48 hours of antibiotic treatment are usually required.

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