Clinical Care of Shigellosis

Key points

  • Healthcare providers may prescribe medicine to treat illness caused by Shigella.
  • However, some antibiotics are not effective against certain types of Shigella.
  • Healthcare providers can order laboratory testing of a sample of a patient's stool to determine if they have a Shigella infection that is resistant to antibiotics.
Healthcare provider speaking with patient

Treatment options

People who have Shigella infection 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 Shigella infection 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.

As a healthcare provider, you can order laboratory tests to determine which antibiotics are likely to work. If your patient does not get better within a couple of days after starting antibiotics, you can do more tests to learn whether their type of Shigella bacteria can be treated effectively with the antibiotic they are taking. If not, consider prescribing another type of antibiotic.

Counseling patients with Shigella infection

Shigella is highly contagious; a very small inoculum (10 to 200 organisms) is sufficient to cause infection.

To prevent the spread of Shigella bacteria, healthcare providers can share these prevention messages with patients with shigellosis:

  • Wash hands with soap and water for at least 20 seconds:
    • After using the toilet
    • After hanging a diaper or assisting anyone with toileting
    • Note: Wash child's hands in addition to your own.
  • Avoid preparing food for friends, neighbors, colleagues, and (if possible) your family while you are sick.
  • Try to stay home while you are sick.
    • If you work in healthcare, childcare, or the food service industry, follow the guidance of your local health department about when it is safe to return to work.
  • Children with shigellosis should not attend childcare, school, or group activities while they have diarrhea. Follow the guidance of your local health department about when it is safe to return to childcare or school.
  • Avoid swimming until you have fully recovered.
  • Wait to have sex (vaginal, anal, and oral) for one week after you no longer have diarrhea. Because Shigella germs may be in stool for several weeks, follow safe sex practices, or ideally avoid having sex, for several weeks after you or your partner have recovered.
  • When you start having sex again, wash your body and hands before and after sex, including in and around the anus and genitals.
    • During oral sex (fellatio or cunnilingus) or oral-anal sex (anilingus or mouth to anus), use barriers, such as condoms, natural rubber latex sheets, dental dams, or cut-open non-lubricated condoms between your rectum and your partner's mouth.
    • Use condoms the right way, every time during anal or vaginal sex. Wash hands after handling used condoms or other barriers.
  • Urge others you know with similar symptoms to seek health care.