Infectious Disease

CDC Offers Recommendations for Treatment of Shigella Infection

Shigella infections should not be treated with antibiotics unless clinically indicated, as in patients who are immunocompromised or have severe illness, or during an outbreak, according to recent recommendations from the CDC.

The CDC released the recommendations in response to recent data indicating increased resistance to fluoroquinolone antibiotics among strains of Shigella bacteria.
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The CDC recommends that clinicians:

  • Order a stool culture for patients suspected of having Shigella infection, in order to test for antimicrobial susceptibility.
  • Do not routinely prescribe antibiotics for Shigella. Instead, reserve antibiotic therapy for patients in which it is clinically indicated, or during an outbreak.
  • When antibiotics are indicated, tailor the choice of antibiotic to antimicrobial susceptibility results as soon as possible.
  • Counsel patients on how to prevent the spread of the bacteria to others, regardless of whether they are taking antibiotics or not.
  • Order follow-up stool cultures in patients who continue to worsen after antibiotic therapy.

The CDC plans to investigate in clinical outcomes are worse in patients infected with resistant Shigella strains who receive ciprofloxacin treatment, and continue to monitor antimicrobial susceptibility of Shigella.

—Michael Potts

Reference: 

CDC Recommendations for diagnosing and managing Shigella strains with possible reduced susceptibility to ciprofloxacin. CDC Health Alert Network. https://emergency.cdc.gov/han/han00401.asp. April 18, 2017.