this the way it went for salmonella back in the 80s, when it was found that salmonella carriage was more persistent after antibiotic use. shigella took a while longer to have the guidelines for treatment changed.
CDC Offers New Advice for Managing Shigella Infection Given Reduced Antibiotic Susceptibility — Physician’s First Watch
CDC Offers New Advice for Managing Shigella Infection Given Reduced Antibiotic Susceptibility
By Kelly Young
Edited by Richard Saitz, MD, MPH, FACP, DFASAM
The CDC is emphasizing that clinicians not treat Shigella infection with antibiotics unless it is clinically indicated — for example, in patients who are immunocompromised or who have severe illness — or during an outbreak. The agency's health advisory comes amid growing fluoroquinolone resistance in Shigella samples.
In suspected cases of shigellosis, clinicians should order stool culture and antimicrobial susceptibility testing. If antibiotics are indicated but the ciprofloxacin minimum inhibitory concentration is 0.12 µg/mL or higher, fluoroquinolones should be avoided and clinicians should consult their clinical microbiology laboratory and an infectious disease specialist to decide on an appropriate antibiotic. For patients with continued or worsening symptoms after antibiotic therapy, follow-up stool culture should be obtained.
The CDC is investigating whether ciprofloxacin treatment could increase illness duration or symptom severity in patients with Shigella harboring a quinolone-resistance gene.