Approach to managing Shigella enteritis (shigellosis)

Antibiotic susceptibility of Shigella strains varies from country to country, and multidrug-resistant strains are present in many regions. There are high levels of antimicrobial resistance among circulating Shigella species in Australia, particularly in gay, bisexual and other men who have sex with men, and transgender women. Request faecal culture and susceptibility testing for cases of suspected Shigella enteritis (shigellosis).

Note: Request faecal culture and susceptibility testing for cases of suspected shigellosis.
Although shigellosis is a self-limiting infection, antibiotic therapy reduces disease transmission and reduces duration of symptoms by about 2 days. Antibiotic therapy is indicated for patients with severe diarrhoea and in patients with immune compromise. Treatment may also be used to reduce transmission in children younger than 6 years, food handlers, healthcare workers, childcare workers, and people living or working in residential aged-care facilities, prisons and other residential facilities.

The mainstay of therapy for shigellosis is rehydration in combination with antimicrobial therapy, when indicated.

Shigellosis is easily transmitted person-to-person and measures to prevent transmission are essential. These include good hygiene practices and staying away from childcare, school or work while unwell. Advise gay, bisexual and other men who have sex with men, and transgender women to abstain from sex while symptomatic and for 7 days after symptoms have resolvedDepartment of Health, 2022.

Patients with undiagnosed HIV infection may present initially with recurrent shigellosis. Recurrent shigellosis is an indicator condition for HIV testing1. If recurrent shigellosis is identified, offer HIV testing, regardless of whether the patient has behavioural or epidemiological risk factors for HIV infection.

1 Indicator conditions for HIV testing are conditions that are seen in people with HIV infection (including undiagnosed infection), conditions that share a transmission route with HIV (eg sexually transmissible infections), or conditions for which management is altered in people with HIV infection (eg tuberculosis).Return