Definition
"Shigellosis" means an intestinal pathology triggered by gram negative bacteria belonging to the genus Shigella: also known as bacillary dysentery, Shigellosis causes purely intestinal problems, which normally resolve in a matter of days. In severe cases, the infection needs 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 (enterobatteriacee), 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 through direct contact with infected animal or human faeces, or with the intake of contaminated food or water. Shigellosis can rarely be transmitted by sexual contact.
Symptoms
The signs and symptoms characteristic of Shigellosis generally begin 2-3 days after exposure to the bacterium: abdominal cramps, diarrhea and fever are the most recurrent symptoms associated with infection, although some affected patients do not complain of any appreciable symptoms.
- Complications (rare): convulsions, dehydration, megacolon, rectal prolapse, hemolytic uremic syndrome
Information on Shigella - Drugs for Shigellosis Care is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Shigella - Drugs for Shigellosis Care.
drugs
Before proceeding with the pharmacological treatment, the diagnostic assessment is essential, therefore the isolation of the bacteria that caused the infection; what has been said is very important, since some Shigella species do not generate appreciable symptoms or disorders in most affected individuals. To give an example, except for some isolated cases, Shigella sonnei does not generate any intestinal symptoms and the infection resolves itself in a few days; so much so that the patient tends not to notice that he has been infected. Different discourse must be addressed for Shigella dissenteriae- supported infections: when it affects children, the elderly and immunocompromised without being treated, this type of Shigellosis can also cause death.
Firstly, the patient must undergo an electrolytic therapy, which consists of 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 electrolyte therapy administered intravenously.
It is recommended to NOT take drugs for the treatment of diarrhea, since, paradoxically, this practice could even exacerbate the problem.
If Shigellosis does not regress in a few days, a specific antibiotic therapy aimed at removing the bacterium is recommended: in general, drug therapy is reserved for children, the elderly and all individuals who experience severe alterations of the immune system, the categories more 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 posology for the patient, based on the severity of the disease, the health of the patient and his response to treatment:
Antibiotic therapy : antibiotics should always be taken with caution, subject to medical prescription. It is recommended not to follow a "do it yourself" therapy, since many bacteria belonging to the genus Shigella develop resistance to many antibiotics. Let us highlight it once again: the antibiotic should only be used in cases of severe shigellosis with the risk of complications.
- Ciprofloxacin (eg. Ciproxin, Flontalexin, Ciprofloxac, Samper): the quinolone derivative is indicated for treating severe shigellosis in weaker patients with impaired immune systems. In this case, it is recommended to take the drug at a dose 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 dose of 1 gram drug 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 an indicative dose 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. However, the dosage involves taking 400 mg of medication by mouth, every 12 hours, for 5 days. For immunocompromised and AIDS patients, it is recommended to prolong 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 of shigellosis. Generally, the 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 an indication, take 1 tablet of 160 mg of trimethoprim and 800 mg of sulfamethoxazole every 12 hours (posology for adults) 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.
- Ceftriaxone (eg Ceftriaxone, Pantoxon, Ragex, Deixim): this is a third-generation cephalosporin particularly indicated for pediatric treatment of Shigellosis. As an indication, 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 given to newborns with hyperbilirubinemia.
Rehydration therapy : in general, for healthy adults, water is sufficient to balance the fluids lost with diarrhea in the context of shigellosis; children can also benefit from this simple trick, especially when water supplements are associated with water. In severe cases, electrolyte therapy is carried out in a hospital environment, through intravenous administration, useful for supplying the body with the essential nutrients it needs in a much faster time compared to oral administration.
Preventive therapy : once again prevention is essential to reduce the risk of shigella contraction, following simple measures of a hygienic-behavioral nature:
- Wash hands thoroughly before handling food, especially after having been in contact with potentially contaminated material
- Do not drink well water
- Always wash the food carefully, especially fruits and vegetables consumed with the peel
- Do not consume sexual intercourse with people at risk, without a condom: let's remember briefly that Shigellosis can also be transmitted via sexual contact (it is one of its health / venereal diseases.html "> venereal diseases)
- Store food in the refrigerator to avoid contact with flies, possible vectors of shigellosis
