Healthcare providers should culture the stool specimens of patients with symptoms consistent with shigellosis, reculture the stool of patients who fail to improve after antimicrobial therapy, and test bacterial pathogens for antimicrobial susceptibility. Reserving antimicrobial treatment for immunocompromised patients and patients with severe shigellosis and using antimicrobial susceptibility data strategically to guide therapy might help preserve the utility of such medications. In the U.S., most Shigella is already resistant to the antibiotics ampicillin and trimethoprim/sulfamethoxazole. Globally, Shigella resistance to ciprofloxacin is increasing. Ciprofloxacin is often prescribed to people who travel internationally, in case they develop diarrhea while out of the United States.

“These outbreaks show a troubling trend in Shigella infections in the United States,” said CDC Director Tom Frieden, MD, MPH. “Drug-resistant infections are harder to treat and because Shigella spreads so easily between people, the potential for more – and larger – outbreaks is a real concern. We’re moving quickly to implement a national strategy to curb antibiotic resistance because we can’t take for granted that we’ll always have the drugs we need to fight common infections.”

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