Antibiotic therapy for Shigella dysentery

Family Medicine, Christian Medical College, Vellore, Tamilnadu, India, 632004.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 08/2010; 8(8):CD006784. DOI: 10.1002/14651858.CD006784.pub4
Source: PubMed


Shigellosis is a bacterial infection of the colon that can cause diarrhoea, dysentery (diarrhoea with blood and/or mucus) and may lead to death. It occurs mainly in low- and middle-income countries where overcrowding and poor sanitation exist, and may lead to around 1.1 million deaths per year globally, mostly in children under five years. The intention of giving antibiotics in shigellosis is to speed recovery, reduce the seriousness of the disease, and reduce the length of time patients are infective. However, some antibiotics can have serious side effects while others may not be effective against the Shigella bacteria. The review examined both the effectiveness and the safety of antibiotics in treating Shigella dysentery. While antibiotics tested here appeared safe and effective, there was insufficient evidence to suggest which antibiotics were superior. More well designed trials will help inform decision making.

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Available from: Venkatesan Pandian, Jun 15, 2015
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    • "Reduced episodes of diarrhoea at follow-up were seen with Furazolidone versus no drug (RR 0.21; 95% CI: 0.09, 0.48) as well as with cotrimoxazole versus no drug (RR 0.30; 95% CI: 0.15, 0.59) [72]. However, treatment with one of the three WHO-recommended antibiotics (ciprofloxacin, ceftriaxone and pivmecillinam) resulted in a clinical failure rate of 0.1% (95% CI: −0.2, 0.5%) [73]. "
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    ABSTRACT: Child health is a growing concern at the global level, as infectious diseases and preventable conditions claim hundreds of lives of children under the age of five in low-income countries. Approximately 7.6 million children under five years of age died in 2011, calculating to about 19 000 children each day and almost 800 every hour. About 80 percent of the world's under-five deaths in 2011 occurred in only 25 countries, and about half in only five countries: India, Nigeria, Democratic Republic of the Congo, Pakistan and China. The implications and burden of such statistics are huge and will have dire consequences if they are not corrected promptly. This paper reviews essential interventions for improving child health, which if implemented properly and according to guidelines have been found to improve child health outcomes, as well as reduce morbidity and mortality rates. It also includes caregivers and delivery strategies for each intervention. Interventions that have been associated with a decrease in mortality and disease rates include exclusive breastfeeding, complementary feeding strategies, routine immunizations and vaccinations for children, preventative zinc supplementation in children, and vitamin A supplementation in vitamin A deficient populations.
    Reproductive Health 08/2014; 11(Suppl 1):S4. DOI:10.1186/1742-4755-11-S1-S4 · 1.88 Impact Factor
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    • "We reviewed the scientific evidence available for the use of antibiotics in the treatment of diarrhea due to Cholera, Shigella and Cryptosporidium in children, as well as differences in the effectiveness of various antibiotics. A Cochrane review [20] has evaluated the effectiveness of antibiotics for Shigella in children and adults, while the review by Traa et al [21] had evaluated the effectiveness of antibiotics for dysentery and estimated a cure rate of > 99%. We in this review have taken studies with confirmed cases of Shigella only, so have estimated the effect of antibiotics on Shigella cases. "
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    ABSTRACT: Diarrhea is a major contributor to the burden of morbidity and mortality in children; it accounts for a median of 11% of all deaths among children aged less than 5 years, amounting to approximately 0.8 million deaths per year. Currently there is a dearth of literature exploring the effectiveness of antibiotics for diarrhea due to Cholera, Shigella and cryptosporidiosis in children. We reviewed the literature reporting the effect of antibiotics for the treatment of diarrhea due to Cholera, Shigella and Cryptosporidium in children under five years. We used a standardized abstraction and grading format and performed meta-analyses to determine the effect of the treatment with various antibiotics on mortality and rates of clinical and bacteriological/parasitological failure. The CHERG Standard Rules were applied to determine the final effect of treatment with antibiotics on diarrhea morbidity and mortality. For Cholera; the evidence was weak to recommend any effect on mortality. For Shigella; there was no data on mortality; either all-cause or cause specific, hence we used clinical failure rates as a proxy for Shigella deaths and propose that treatment of Shigella dysentery with antibiotics can result in a 82% reduction in diarrhea mortality due to Shigella. For cryptosporidiosis; there was data on all-cause mortality but the evidence was weak hence we used clinical failure rates as a proxy for mortality to estimate that antimicrobial treatment of diarrhea due to cryptosporidiosis can result in a 54% reduction in mortality. There is evidence to recommend antibiotic use for reduction of morbidity and mortality due to Cholera, Shigella and Cryptosporidium. We recommend that more clinical trials should be conducted to evaluate the efficacy and safety of first- and second- line drugs currently in use for treatment for diarrhea and dysentery in both developing and developed countries.
    BMC Public Health 09/2013; 13 Suppl 3(Suppl 3):S10. DOI:10.1186/1471-2458-13-S3-S10 · 2.26 Impact Factor
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    • "Ampicillin and trimethoprim-sulfamethoxazole are no longer sufficiently effective due to increases in the bacterial resistance to these drugs [4]. Because of concerns regarding the adverse effects of ciprofloxacin in children and an increase in the resistance to ciprofloxacin, third generation cephalosporins are frequently used as alternative treatments [2, 4]. However, Shigella species producing CTX-M-type β-lactamase are frequently being reported in some parts of the world [1, 5-7]. "
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    ABSTRACT: We report a case of CTX-M-55-type extended-spectrum β-lactamase (ESBL)-producing Shigella sonnei infection in a 27-year-old Korean woman who had traveled to China. The patient was admitted to the hospital due to abdominal pain, watery diarrhea, and fever (39.3℃). S. sonnei was isolated from her stool specimens, and the pathogen was found to be resistant to cefotaxime due to CTX-M-55-type ESBL. Insertion sequence (IS)Ecp1 was found upstream of the bla CTX-M-55 gene. The bla CTX-M-55 gene was transferred from the S. sonnei isolate to an Escherichia coli J53 recipient by conjugation. Pulsed-field gel electrophoresis and Southern blotting revealed that the bla CTX-M-55 gene was located on a plasmid of approximately 130 kb.
    Annals of Laboratory Medicine 03/2013; 33(2):141-144. DOI:10.3343/alm.2013.33.2.141 · 1.48 Impact Factor
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