Shigellosis medical therapy
|
Shigellosis Microchapters |
|---|
|
Diagnosis |
|
Treatment |
|
Case Studies |
|
Shigellosis medical therapy On the Web |
|
American Roentgen Ray Society Images of Shigellosis medical therapy |
|
Risk calculators and risk factors for Shigellosis medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Medical Therapy
Fluid Replacement
- As with any infectious diarrhea, the most important initial step in the management of patients with shigellosis is fluid and salt replacement.
- Oral fluid replacement is sufficient for the majority of patients, and can be accomplished with oral glucose or starch-containing electrolyte solutions. Oral rehydration solutions should contain the WHO-recommended electrolyte concentrations (Na 90 mM, K 20 mM, Cl 80 mM, HCO3 30 mM, and glucose 111 mM).
- Oral fluid replacement is superior to IV fluids for patients who can tolerate it.
- Oral rehydration solutions can be prepared by mixing 3.5 g of NaCl, 2.5 g of NaHCO3 (or 2.9 g of Na citrate), 1.5 g of KCl, and 20 g of glucose or glucose polymer (e.g., 40 g of sucrose or 4 tablespoons of sugar or 50–60 g of cooked cereal flour such as rice, maize, sorghum, millet, wheat, or potato) per liter of clean water.
- IV fluid replacement should be tailored to the individual patient's lab findings (electrolytes, BUN, creatinine).
Symptomatic Treatment
- Antimotility agents (such as diphenoxylate or loperamide) are not recommended for patients with documented Shigella infections. These agents may prolong the infection and increase the shedding of Shigella organisms.
Antibiotic Therapy
Antibiotics such as trimethoprim-sulfamethoxazole, norfloxacin, ciprofloxacin, or furazolidone may be given when the person is very young or very old, when the disease is severe, or when there is a high risk of the infection spreading to other people. The severity of the symptoms and the length of time the stool contains Shigella are reduced with antibiotics.