Shigellosis is an intestinal infection that can strike suddenly, turning daily life upside down with symptoms like stomach cramps, fever, and diarrhea that is often bloody. The urgency and discomfort associated with this condition can make leaving the house difficult and stressful. While the body can often fight off mild infections on its own, the symptoms can be physically exhausting and worrisome, especially for parents of young children who are frequently affected.

Treatment is critical not only to relieve these distressing symptoms but also to prevent serious complications like severe dehydration. Furthermore, treating the infection helps stop the spread of the bacteria to family members and the community. Because the severity of Shigellosis ranges from mild discomfort to illness requiring hospitalization, treatment plans are tailored to the patient’s age, health status, and the severity of the symptoms (Centers for Disease Control and Prevention, 2023).

Overview of treatment options for Shigellosis

The primary goals of treating Shigellosis are to replace lost fluids and clear the bacterial infection. For many healthy adults with mild symptoms, the focus is strictly on rehydration, drinking plenty of water and electrolyte solutions to replace what is lost through diarrhea. In these cases, doctors often recommend waiting for the infection to pass naturally to avoid the risk of antibiotic resistance.

However, for severe cases, or for patients with weakened immune systems, infants, and the elderly, medication is essential. The medical approach relies on antibiotics to shorten the duration of the illness and reduce the risk of transmission. It is important to note that unlike other forms of diarrhea, doctors generally advise against using anti-diarrheal medications (antimotility drugs) for Shigellosis, as these can trap the bacteria in the gut and worsen the infection.

Medications used for Shigellosis

When medication is necessary, antibiotics are the standard line of treatment. The choice of drug is often guided by laboratory tests, as Shigella bacteria have developed resistance to many common drugs.

Fluoroquinolones, such as ciprofloxacin, are frequently the first-line choice for adults. These are powerful oral antibiotics that are highly effective at targeting the bacteria in the digestive tract. Clinical experience suggests that appropriate antibiotic treatment can shorten the duration of fever and diarrhea by about two days.

For children, who generally should not take fluoroquinolones, macrolides are the preferred option. Azithromycin is the most common medication in this class prescribed for pediatric cases. It is generally well-tolerated and effective.

In more severe cases requiring hospitalization, or when oral medication is not possible, third-generation cephalosporins like ceftriaxone may be administered via injection. Typical expectations for patients starting these medications include a noticeable reduction in fever and abdominal pain within 48 hours (Mayo Clinic, 2022).

How these medications work

Antibiotics treat Shigellosis by directly attacking the biological processes of the Shigella bacteria. Fluoroquinolones work by interfering with the bacteria’s DNA. Specifically, they block the enzymes the bacteria need to copy their genetic material. Without the ability to replicate their DNA, the bacteria cannot multiply and eventually die.

Macrolides like azithromycin work differently; they inhibit the bacteria’s ability to produce essential proteins. By binding to specific parts of the bacterial cell, they stop the growth of the bacteria, allowing the body’s immune system to clear the remaining infection more easily. Cephalosporins attack the bacterial cell wall, causing the bacteria to become unstable and burst. These mechanisms ensure that the bacterial load in the intestines is reduced rapidly (National Institutes of Health, 2020).

Side effects and safety considerations

While antibiotics are effective, they can cause side effects. Common side effects include nausea, stomach upset, and mild diarrhea, which can complicate intestinal infection diagnosis. Fluoroquinolones rarely risk tendon inflammation or rupture.

A major concern with Shigellosis is antibiotic resistance; lack of improvement may require a drug change. Patients should avoid anti-diarrheals like loperamide unless advised by a doctor. Seek immediate medical attention for severe dehydration (e.g., no urination, dizziness, confusion) or worsening bloody diarrhea despite treatment.

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

1. Centers for Disease Control and Prevention. https://www.cdc.gov
2. Mayo Clinic. https://www.mayoclinic.org
3. National Institutes of Health. https://www.nih.gov
4. World Health Organization. https://www.who.int