Extensively drug-resistant Shigella is making a once-treatable diarrheal infection harder to manage. The CDC warns that there is no Food and Drug Administration-approved oral treatment for XDR shigellosis, while the bacteria can continue spreading after symptoms end.
What is happening
Shigella is a bacterium that causes shigellosis, an intestinal infection marked by diarrhea, fever and stomach cramps. It spreads through the fecal-oral route, including sexual contact, and can pass easily because only 10 to 100 organisms can cause infection.
The CDC defines extensively drug-resistant (XDR) Shigella as resistant to five common antibiotics: azithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole and ampicillin. The agency says no FDA-approved oral treatment is available for XDR shigellosis.
What it means for patients
If you experience bloody diarrhea, fever, and severe cramping, seek medical care rather than taking leftover antibiotics. Extensively drug-resistant Shigella requires clinical assessment and appropriate testing. During diarrhea and for two weeks after it ends, the CDC advises abstaining from anal, oral, penile and vaginal sex; people who resume sex should follow safer-sex practices for at least two weeks.
Can it clear without antibiotics?
*Can extensively drug-resistant Shigella clear without antibiotics? Many people with mild shigellosis recover with rest and fluids, but XDR infections can be difficult to treat because commonly used oral antibiotics may not work. Anyone with severe symptoms, bloody diarrhea, dehydration or a weakened immune system should seek medical care.
CDC guidance says people can shed Shigella in stool for weeks after diarrhea ends. That makes handwashing, safe food handling and safer-sex practices important after symptoms improve.
CDC surveillance updates on XDR Shigella* are expected in future reports. Check back for updates.
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