Treatment of Shigella Infection
Shigella usually resolves on its own without the use of antibiotics and it is debatable as to whether or not the use of antibiotics shortens the course of the illness. The use of antibiotics is not without risks of its own, including, ironically, the development of other infections which cause diarrhea, as well as other gastrointestinal distress of other causes. In addition, the use of antibiotics when not absolutely necessary increases the risk of the development of resistance to these drugs among the bacterial population, a situation that is growing increasingly dire over time. However, people suffering severe symptoms or those who immune compromised may be candidates for treatment. Treatment can also be important in situations where the disease is spreading rapidly due to poor sanitation systems as treatment can eradicate the Shigella organism and stop person-to-person spread of the infection. Because Shigella are intrinsically resistant to many antibiotics, especially strains acquired from outside the United States, it is critical that the laboratory perform antibiotic sensitivity testing to determine which antibiotics will be effective against any one particular infection. No one should ever take antibiotics not prescribed by a qualified physician and dispensed by a licensed pharmacist! Self-treatment of presumed infections almost always does more harm than good in the long run.
Prevention of Shigella Infection
Currently, there is no vaccine to prevent Shigella infection. However, the spread of Shigella from an infected person to other persons can be stopped by frequent and careful hand washing. Hand washing is important among all age groups. Hand washing among children should be frequent and supervised by an adult in daycare centers and homes with children who have not been fully toilet trained.
If a child in diapers has Shigella, everyone who changes the child’s diapers should be sure the diapers are disposed of properly in a closed-lid garbage can, and should wash his or her hands and the child’s hands carefully with soap and warm water immediately after changing the diapers. After use, the diaper changing area should be wiped down with a disinfectant with demonstrated effectiveness against Shigella bacteria. When possible, young children with a Shigella infection who are still in diapers should not be in contact with uninfected children.
Basic food safety precautions and disinfection of drinking water prevents Shigella infection associated with food and water. At swimming beaches, having enough bathrooms and hand washing stations with soap near the swimming area helps keep the water from becoming contaminated. Daycare centers should not provide water play areas.