Abstract :
Shigellosis is an important public health problem, especially in developing countries. Antibiotic
treatment of bacterial dysentery, aimed at resolving diarrhea or reducing its duration is especially indicated
whenever malnutrition is present. First-line drugs include ampicillin and trimethoprim sulfamethoxazole(
TMP-SMX); however multidrug-resistance has occurred and careful antibiotic selection must be considered
in prescribing .When epidemiologic data indicate a rise in resistancy, fluoroquinolones may be used in
adults and oral third-generation cephalosporins and nalidixic acid in children. All children (n=2400) with
acute diarrhea who were admitted to the Pediatric department of Dr.sheykh Hospital Mashhad, Iran from
March 2004 to March 2005 were selected and their stool culture were obtained, then positive cultures (312
cases,13% ) were evaluated by antibiogram. This study showed that in heavily populated areas of IRAN like
Mashhad, 97% shigella strain isolated from children with bloody diarrhea were sensitive to nalidixic acid,
ciprofloxacin and cefixime and rarely susceptible to ampicillin and cotrimoxazole. There is increasing resistance
of Shigella to most of the antibiotics in use, and for this reason, careful selection of antibiotics must use
considered in each area. Development and use of new drugs are expensive and have severe limitations in the
third world. Simple prophylactic alternatives are therefore, required, such as awareness of hygienic child care
practices and early promotion of breast feeding. For treatment of shigellosis in infants Ceftriaxon, and in
children Nalidixic Acid is recommended.
