Definition
By "Shigellosis" we mean an intestinal pathology triggered by gram negative bacteria belonging to the Shigella genus: also known as bacillary dysentery, Shigellosis causes purely intestinal problems, which normally resolve in a few days. In the most serious cases, the " infection requires antibiotic drugs to be eradicated.
Causes
Shigellosis is the consequence of an insult sustained by gram negative bacteria, belonging to the same family as Salmonella and E. coli (Enterobacteriaceae), and to the genus Shigella; in particular, the species most involved are Shigella dysenteriaee, Shigella flexeneri, Shigella boyidii and Shigella sonnei. The pathogen can be transmitted either by direct contact with infected animal or human feces, or by ingesting contaminated food or water. Shigellosis can rarely be transmitted by sexual contact.
Symptoms
The characteristic signs and symptoms of Shigellosis generally begin 2-3 days after exposure to the beat: abdominal cramps, diarrhea and fever are the most recurrent symptoms associated with the infection, although some affected patients do not complain of any appreciable symptoms.
- Complications (rare): seizures, dehydration, megacolon, rectal prolapse, haemolytic uremic syndrome
The information on Shigella - Drugs for the Treatment of Shigellosis is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Shigella - Drugs to Treat Shigellosis.
Medicines
Before proceeding with the pharmacological treatment it is essential the diagnostic assessment, therefore the isolation of the bacteria that caused the infection; what has been said is very important, since some species of Shigella do not generate appreciable disturbances or symptoms in most individuals. affected. To give an example, except for a few isolated cases,Shigella sonnei it does not generate any intestinal symptoms and the "infection resolves itself in a few days; so much" that the patient tends not to notice that he has been infected. Different speech must be addressed for the infections sustained by Shigella dysenteriae: when it affects children, the elderly and immunocompromised without being treated, this type of Shigellosis can also cause death.
First of all, the patient must be subjected to electrolytic therapy, which consists in the generous rehydration of liquids and mineral salts - especially calcium, potassium and sodium - lost with diarrhea; in the most serious cases, the patient is hospitalized and the therapy electrolyte administered intravenously.
It is recommended NOT to take drugs to treat diarrhea, since, paradoxically, this practice could even exacerbate the problem.
If the Shigellosis does not regress in a few days, a specific antibiotic therapy is recommended, aimed at "removing the bacterium: in general, drug therapy is reserved for children, the elderly and all individuals who register serious changes in the immune system, categories most exposed to the risk of complications.
The following are the classes of drugs most used in therapy against Shigellosis, and some examples of pharmacological specialties; it is up to the doctor to choose the most suitable active ingredient and dosage for the patient, based on the severity of the disease, the state of health of the patient and his response to treatment:
Antibiotic therapy: Antibiotics must always be taken with caution, with a medical prescription. It is recommended not to follow a "do it yourself" therapy, since many bacteria belonging to the Shigella genus develop resistance to numerous antibiotics. Let us highlight it once again: the antibiotic should only be used in case of severe shigellosis with risk of complications.
- Ciprofloxacin (eg Ciproxin, Flontalexin, Ciprofloxac, Samper): the quinolone derivative is indicated to treat severe Shigellosis in weaker patients with impaired immune system. In this case, it is recommended to take the drug at a dosage of 500 mg, orally, twice a day for 3 days. For AIDS patients, prolong the therapy for 7 days. For Shigellosis not accompanied by dysentery, a single 1-gram dose of medication is usually sufficient. Consult your doctor.
- Ofloxacin (eg. Exocin, Oflocin): the drug, belonging to the class of quinolones, should be taken for the treatment of severe Shigellosis at the indicative dosage of 200-400 mg, to be taken orally every 12 hours, for 3-5 days.
- Lomefloxacin (eg Levofloxacin, Tavanic, Aranda, Fovex): this drug, like the previous ones, belongs to the pharmacological class of quinolones; the dosage for the treatment of Shigellosis suggests taking 400 mg of active per day, for 3-5 days.
- Norfloxacin (eg. Noroxin, Norflox, Flossac, Sebercim): the drug is a quinolone not approved by the FDA for the treatment of Shigellosis. In any case, the dosage foresees to take 400 mg of the drug by mouth, every 12 hours, for 5 days. For immunocompromised and AIDS patients, it is recommended to extend therapy for 7-10 days. Consult your doctor.
- Sulfamethoxazole + trimethoprim (eg Bactrim): the pharmacological preparation is formulated with two active sulfonamides which, acting in synergy, enhance the therapeutic effect, speeding up the healing time from shigellosis. Generally, sulfamethoxazole and trimethoprim that make up each tablet are formulated in a 5: 1 ratio: for example, one tablet may contain 400 mg of sulfamethoxazole and 80 mg of trimethoprim. As a guideline, take 1 tablet of 160 mg of trimethoprim and 800 mg of sulfamethoxazole every 12 hours (adult dosage) for at least 5 days. The drug can also be administered intravenously: 8-10 mg / kg per day, in 2-4 doses (every 6-8-12 hours) for 5 days. Do not exceed 960 mg of trimethoprim per day. day.
- Ceftriaxone (eg. Ceftriaxone, Pantoxon, Ragex, Deixim): it is a third generation cephalosporin particularly suitable for the pediatric treatment of Shigellosis. Indicatively, take the drug intravenously at a dose of 50-75 mg / kg per day, for 2-5 days. For children with AIDS, prolong the therapy for 10 days. The drug can also be administered to infants suffering from hyperbilirubinemia.
Rehydration therapy: in general, for healthy adults, water is sufficient to rebalance the fluids lost with diarrhea in the context of shigellosis; even children can benefit from this simple measure, especially when supplements are combined with water. saline. In severe cases, electrolyte therapy is carried out in a hospital setting, through intravenous administration, which is useful for supplying the body with the essential nutrients it needs much faster than oral administration.
Preventive therapy: once again, prevention is essential to reduce the risk of Shigella contraction, following simple hygienic-behavioral precautions:
- Wash your hands thoroughly before handling food, especially after having been in contact with potentially contaminated material
- Do not drink well water
- Always carefully wash food, especially fruit and vegetables eaten with the peel
- Do not consume sexual intercourse with subjects at risk, without a condom: we briefly remember that Shigellosis can also be transmitted sexually (it is part of the health / venereal diseases.html "> venereal diseases)
- Store food in the refrigerator to avoid contact with flies, possible vectors of shigellosis
