Infectious Dis. Medical News about Dysentery Shigella Anti-Bacterial Agents

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Antibiotic therapy for Shigella dysentery
Cochrane Reviews, 10/22/09

Christopher PRH et al. – The review examined both the effectiveness and the safety of antibiotics in treating Shigella dysentery. Sixteen trials (1748 participants), spanning four decades and with differing sensitivity to Shigella isolates, met the inclusion criteria. Seven were judged to be at risk of bias due to inadequate allocation concealment or blinding, and 12 due to incomplete reporting of outcome data. Limited data from one three–armed trial of people with moderately severe illness suggest that antibiotics reduce the episodes of diarrhoea at follow–up (furazolidone versus no drug RR 0.21, 95% CI 0.09 to 0.48, 73 participants; cotrimoxazole versus no drug RR 0.30, 95% CI 0.15 to 0.59, 76 participants). There was insufficient evidence to consider any class of antibiotic superior in efficacy in treating Shigella dysentery, but heterogeneity for some comparisons limits confidence in the results. All the antibiotics studied were safe. There was inadequate evidence regarding the role of antibiotics in preventing relapses. More well designed trials will help inform decision making.

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