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Epithelial Cell Infection Analyses with Shigella
Published on: February 9, 2024
Options for treating resistant Shigella species infections in children
Sharon M Erdman1, Elizabeth E Buckner, Janet F Hindler
1Purdue University School of Pharmacy, Department of Pharmacy Practice, Indianapolis, Indiana.
Insights
Shigella infections, a major cause of bloody diarrhea, show increasing antibiotic resistance. Alternative antibiotics like cefixime and azithromycin are recommended for children under five, who are most affected.
Area of Science:
- Pediatric infectious diseases
- Antimicrobial resistance
- Public health microbiology
Background:
- Shigella species cause significant morbidity and mortality globally, particularly in developing nations.
- Shigellosis is a common cause of bloody diarrhea, with 10,000-15,000 cases reported annually in the US.
- Increasing resistance to first-line antibiotics (ampicillin, trimethoprim-sulfamethoxazole) complicates treatment.
Observation:
- Approximately 37% of Shigella isolates exhibit resistance to both ampicillin and trimethoprim-sulfamethoxazole.
- Children under five years old account for about 69% of Shigella infections.
- The American Academy of Pediatrics (AAP) recommends alternative antibiotics for pediatric shigellosis.
Findings:
- This review examines the microbiology, susceptibility, efficacy, and safety of alternative antibiotics for pediatric Shigella infections.
- Alternative agents include cefixime, ceftriaxone, azithromycin, and fluoroquinolones.
- Data supports the use of these alternatives in treating pediatric shigellosis.
Implications:
- Effective alternative antibiotic options are crucial for managing pediatric shigellosis due to rising antimicrobial resistance.
- This review aims to guide the appropriate selection of alternative antibiotics for children.
- Optimizing treatment strategies is essential to reduce the public health burden of Shigella infections in pediatric populations.
Abstract:
Infection due to Shigella species remains an important public health problem, especially in developing countries where it remains the most common cause of bloody diarrhea. In the United States (US), 10,000 to 15,000 cases of shigellosis are reported each year in both children and adults. US surveillance data from 2004 has demonstrated increased resistance in Shigella species to first-line antibiotics such as ampicillin and trimethoprim-sulfamethoxazole, with approximately 37% of isolates demonstrating resistance to both ampicillin and trimethoprim-sulfamethoxazole. Since approximately 69% of Shigella infections occur in children younger than 5 years of age, it is important that alternative antibiotics other than typical first-line agents such as ampicillin and trimethoprim-sulfamethoxazole be available to treat Shigella infections in this population. The American Academy of Pediatrics (AAP) recommends cefixime, ceftriaxone, azithromycin, and fluoroquinolones as alternative antibiotics for the treatment of Shigella species infections in children. This paper will review the microbiology, susceptibility, efficacy and safety data of these alternative antibiotics with regard to the treatment of Shigella species infections in children, and will attempt to define the role of each of these agents in the pediatric population.
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