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Related Experiment Videos

Antimicrobial therapy for shigellosis.

M A Salam1, M L Bennish

  • 1Dhaka Treatment Center, International Center for Diarrhoeal Disease Research, Bangladesh.

Reviews of Infectious Diseases
|March 1, 1991
PubMed
Summary

Antimicrobial treatments for shigellosis can shorten illness duration and reduce pathogen shedding. However, increasing drug resistance necessitates evaluating new agents like cephalosporins for effective Shigella treatment.

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Area of Science:

  • Infectious Diseases
  • Microbiology
  • Clinical Pharmacology

Background:

  • Controlled clinical trials demonstrate antimicrobial efficacy in treating shigellosis, reducing symptom duration and pathogen excretion.
  • Not all in vitro active antimicrobials are effective in vivo; clinical trials are essential for assessing efficacy.
  • Increasing resistance to ampicillin and trimethoprim-sulfamethoxazole (drugs of choice) among Shigella isolates, particularly Shigella dysenteriae type I, is a growing concern globally.

Purpose of the Study:

  • To review the efficacy of various antimicrobial agents for treating shigellosis.
  • To highlight the challenge of antimicrobial resistance in Shigella infections.
  • To identify promising alternative and novel antimicrobial agents for Shigella treatment.

Main Methods:

  • Review of controlled clinical trials on antimicrobial agents for shigellosis.
  • Assessment of in vitro and in vivo antimicrobial activity against Shigella species.
  • Analysis of emerging antimicrobial resistance patterns in Shigella isolates.

Main Results:

  • Sulfonamides were among the first agents shown effective in clinical trials.
  • Nalidixic acid, newer quinolones, and amdinocillin pivoxil have demonstrated efficacy in clinical trials.
  • Resistance to ampicillin and trimethoprim-sulfamethoxazole is common in certain Shigella strains and increasing in others.
  • Quinolones require further safety data for pediatric use.
  • Second- and third-generation cephalosporins show high in vitro activity against most Shigella strains and warrant evaluation.

Conclusions:

  • Antimicrobial therapy is crucial for managing shigellosis, but resistance is a significant challenge.
  • Nalidixic acid, quinolones, and amdinocillin pivoxil represent effective treatment options.
  • Further research, particularly on safety in children, is needed for quinolones.
  • Orally administered second- and third-generation cephalosporins are promising candidates for future Shigella treatment strategies.

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