Nelson Textbook of Pediatrics 22nd Edition | Shigella species (S. sonnei, S. flexneri, S. dysenteriae), dysentery (bloody diarrhea, fever, abdominal cramps), Shiga toxin (S. dysenteriae type 1 β HUS), treatment (azithromycin, ceftriaxone), antibiotic resistance (fluoroquinolone, macrolide), prevention (hand hygiene).
π paeds.online β Pakistan's Pediatric Platform| Drug | Dose | Duration | Notes |
|---|---|---|---|
| Azithromycin | 12 mg/kg on day 1 (max 500 mg), then 6 mg/kg/day (max 250 mg) on days 2-5 | 5 days | Drug of choice (increasing resistance in MSM, international travel) |
| Ceftriaxone | 50 mg/kg IM/IV once daily (max 1.5 g) | 3-5 days | Alternative for severe disease or unable to tolerate oral |
| Ciprofloxacin | 15 mg/kg/dose PO BID (max 500 mg/dose) | 3 days | Increasing resistance; use only if susceptible |
| TMP-SMX | 4 mg/kg TMP component BID | 5 days | High resistance; not recommended empirically |