Which treatment is the first line for severe Shigella infection?

For severe Shigella infection, trimethoprim-sulfamethoxazole is considered a first-line treatment option. This antibiotic has been historically used due to its efficacy against Shigella species, which are known to cause gastrointestinal infections characterized by dysentery and diarrhea. The mechanism of action involves inhibiting bacterial folic acid synthesis, which is crucial for bacterial growth and replication.

Resistance patterns may be observed with some antibiotics; however, trimethoprim-sulfamethoxazole remains a critical option in many cases, especially considering the severity of symptoms presented by patients with Shigella. The choice of this antibiotic aligns with clinical guidelines that recommend its use in treating moderate to severe cases.

While other antibiotics, such as azithromycin and rifaximin, might also be effective in certain circumstances or in cases of specific resistance patterns, trimethoprim-sulfamethoxazole is still prominently featured in treatment protocols for its broad-spectrum activity against this pathogen in severe infections.