Shigella infection , treatment

Antibiotics have a recognized role in the treatment of culture-proven bacterial causes of symptomatic enteric infection such as Shigella spp., Campylobacter jejuni and Salmonella typhi. The use of antibiotics in the treatment... 

TMP-SMX is also used in the treatment of infection caused by ampicillin-resistant Shigella spp. and for antibiotic-resistant Salmonella spp.. The combination is also effective for covering the carrier state of Salmonella typhi, the agent of typhoid fever, and other Salmonella spp.. Successful treatment of traveler s diarrhea due to susceptible E. coli is another advantage of the use of this combination. The combination is not indicated in the therapy of enterohemorrhagic E. coli strains such as 0157 H7 because of the risk of developing hemolytic-uremic syndrome associated with the release of the cytotoxic enterotoxin by the drugs. 

Ciprofloxacin is approved for use in the treatment of bone and joint infections, infectious diarrhea caused by Shigella or Campylobacter, lower respiratory tract infections, skin infections, and urinary tract infections. It is the drug of choice for the treatment of infections caused by Campylobacter jejuni. In addition, it has found off-label use as an alternative drug for the treatment of gonorrhea, salmonella, and yersinia... 

Ciprofloxacin and ofloxacin have broader spectra of activity that includes some gram-positive organisms so they have been used for a broad range of infections. Oral ciprofloxacin or ofloxacin is indicated for the treatment of complicated urinary tract infections and prostatitis. Ofloxacin is an effective therapy for chlamydial urethritis/ cervicitis and acute pelvic inflammatory disease. Oral ciprofloxacin or ofloxacin is effective in the treatment of acute diarrhea caused by enterotoxic E. coli (e.g., travelers diarrhea). Salmonella, Shigella, and Campylobacter... 

Increased susceptibility to bacterial infections was reported in two monkeys after dietary exposure to approximately 0.1-0.2 mg/kg/day Aroclor 1248 (Barsotti et al. 1976). The monkeys, which died after 173 and 310 days of treatment, had clinical signs of PCB toxicity and developed, terminally, a severe enteritis from which Shigella flexneri type IV was isolated. 

Diphenoxylate is an opiate (schedule V) with antidiarrheal properties. It is usually dispensed with atropine and sold as Lomotil. The atropine is added to discourage the abuse of diphenoxylate by narcotic addicts who are tolerant to massive doses of narcotic but not to the CNS stimulant effects of atropine. Diphenoxylate shonld be used cautiously in patients with obstructive jaundice because of its potential for hepatic coma, and in patients with diarrhea cansed by pseudomembranous colitis because of its potential for toxic megacolon. In addition, it should be used cautiously in the treatment of diarrhea caused by poisoning or by infection by Shigella, Salmonella, and some strains of E. coli because expulsion of intestinal contents may be a protective mechanism. Diphenoxylate should be used with extreme caution in patients with impaired hepatic function, cirrhosis, advanced hepatorenal disease, or abnormal liver function test results, because the drug may precipitate hepatic coma. Because diphenoxylate is structurally related to meperidine, it may cause hypertension when combined with monoamine oxidase inhibitors. As a narcotic, it will augment the CNS depressant effects of alcohol, hypnotic-sedatives, and numerous other drugs, such as neuroleptics or antidepressants that cause sedation. 

Orally admiifistered trimethoprim is used in the treatment of chroific recurring urinary tract infection. Oral forms of trimethoprim-sulfamethoxazole are used in Shigella and some Salmonella infections, particularly when they are... 

Orally administered trimethoprim is used in the treatment of chronic recurring urinary tract infection. Oral forms of trimethoprim-sulfamethoxazole are used in Shigella and some Salmonella infections, particularly when they are resistant to ampicillin and chloramphenicol. High doses of oral trimethoprim-sulfamethoxazole are used in Pneumocystis pneumonia. This combination, along with polymyxin, has been shown to be effective in treating sepsis caused by Serratia or Pseudomonas organisms. 

Ampicillin is essentially equivalent to benzylpenicillin for pneumococcal, streptococcal, and meningococcal infections, and many strains of Gram-negative Salmonella, Shigella, Proteus mirabllls, and Escherichia coll, as well as many strains of Haemophilus influenzae and Neisseria gonorrhoeae, respond well to oral treatment with ampicillin. 

Many different kinds of diseases can cause diarrhea and bloody diarrhea, and the treatment depends on w hich germ is causing the diarrhea. Determining that Shigella is the cau.se of the illness depends on laboratory tests that identify Shigella in the stools of an infected person. These tests are sometimes not performed unless the laboratory is instructed specifically to look for the organism. The laboratory can also do special tests to tell which type of Shigella the person has and which antibiotics, if any, would be best (o treat it. 

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