Treatment of Shigella Infection

Key points

  • People with Shigella infection usually get better without antibiotic treatment in 5 to 7 days.
  • People with Shigella infection should drink plenty of fluids to prevent dehydration.
  • People with bloody diarrhea should not use anti-diarrheal medicines such as loperamide (Imodium) or diphenoxylate with atropine (Lomotil). These medicines may make symptoms worse.
Doctor and patient

Treatment overview

People who have shigellosis usually get better without antibiotic treatment in 5 to 7 days. People with mild shigellosis may need only fluids and rest. Bismuth subsalicylate (for example, Pepto-Bismol) may be helpful, but people sick with shigellosis should not use medications that cause the gut to slow down and interfere with the way the body digests food, such as loperamide (for example, Imodium) or diphenoxylate with atropine (for example, Lomotil).

Healthcare providers may prescribe antibiotics for people with severe cases of shigellosis to help them get better faster. However, some antibiotics are not effective against certain types of Shigella. Healthcare providers can order laboratory tests to determine which antibiotics are likely to work. Tell your healthcare provider if you do not get better within a couple of days after starting antibiotics. They can do more tests to learn whether your type of Shigella bacteria can be treated effectively with the antibiotic you are taking. If not, your doctor may prescribe another type of antibiotic.

Get Treatment

Contact your healthcare provider if you or one of your family members has bloody or prolonged diarrhea (diarrhea lasting more than 3 days) or severe stomach cramping or tenderness, especially if you also have a fever or feel very sick. Tell your healthcare provider if you have other medical conditions or a weakened immune system—for example, because of an HIV infection or chemotherapy treatment. If you have a weakened immune system, you may be more likely to become severely ill.

  • People with Shigella infection should drink plenty of fluids to prevent dehydration.
  • People with bloody diarrhea should not use anti-diarrheal medicines, such as loperamide (Imodium) or diphenoxylate with atropine (Lomotil). These medicines may make symptoms worse.
  • Antibiotics can shorten the time you have fever and diarrhea by about 2 days.
  • Ciprofloxacin and azithromycin are two recommended oral antibiotics.

If your healthcare provider prescribes an antibiotic, take it exactly as directed and finish taking all the pills even if you feel better.