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Diagnosis and Treatment

CDC Health Advisory: Recommendations for managing and reporting Shigella infections with possible reduced susceptibility to ciprofloxacin.

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Diagnosis

Many kinds of germs can cause diarrhea. Knowing which germ is causing an illness is important to help guide appropriate treatment. Healthcare providers can order laboratory tests to identify Shigella germs in the stool (poop) of someone who is sick.

Doctor consulting with patient

Treatment

Most people will recover from shigellosis without treatment in 5 to 7 days. People who have shigellosis should drink plenty of fluids to prevent dehydration. Contact your healthcare provider if you, or one of your family members, have a fever, bloody diarrhea, severe stomach cramping or tenderness, are dehydrated, or feel very sick. People who are in poor health or who have weakened immune systems, such as from HIV/AIDS or chemotherapy treatment for cancer, also should contact their healthcare provider because they are more likely to get sick for a longer period of time.

  • In some people, bismuth subsalicylate (for example, Pepto-Bismol) can help to relieve symptoms 1,2.
  • People with shigellosis should not use anti-diarrheal medication, such as loperamide (for example, Imodium) or diphenoxylate with atropine (for example, Lomotil). These medications may make symptoms worse 3.
  • Healthcare providers may prescribe antibiotics for some people who have severe cases of shigellosis. Antibiotics such as ciprofloxacin (common treatment for adults), and azithromycin (common treatment for children) are useful for severe cases of shigellosis because they can help people get better faster 4. However, some antibiotics are not effective against certain types of Shigella bacteria. Healthcare providers can order laboratory tests to determine which antibiotics are likely to work.

People who have shigellosis should follow their healthcare provider’s advice. If your healthcare provider prescribes antibiotics, let them know if you do not get better within a couple of days after starting the medication. 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.

For more information on antibiotic resistance, visit the Antibiotic-Resistant Shigella page.

For information on medical management of shigellosis and counseling patients with drug-resistant shigellosis, visit the Information for Healthcare Professionals page.

References
  1. Pathophysiology of gastrointestinal infections: the role of bismuth subsalicylate. Scottsdale, Arizona, 11-14 February 1988. Proceedings. Rev Infect Dis. 1990;12 Suppl 1:S1-119.
  2. Steffen R. Worldwide efficacy of bismuth subsalicylate in the treatment of travelers’ diarrhea. Rev Infect Dis. 1990;12 Suppl 1:S80-6.
  3. DuPont HL, Hornick RB. Adverse effect of lomotil therapy in shigellosis. JAMA. 1973;226(13):1525-8.
  4. Christopher PR, David KV, John SM,and Sankarapandian V. Antibiotic therapy for Shigella dysentery. Cochrane Database Syst Rev. 2010;(8):CD006784.
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