[Antibiotic treatment of Shigella sonnei gastroenteritis].
THE INTEREST OF ANTIBIOTIC TREATMENT OF SHIGELLA INFECTIONS: to reduce the carriage and contamination, duration of the symptoms and the risk of complications.
Over the past years, strains of Shigella sonnei have become resistant to aminopenicillin and cotrimoxazole (treatment recommended till now) and now predominate. INTER-HUMAN TRANSMISSION: The Shigella reservoir is human. The bacteria are easily transmitted in fecal-oral mode. The populations most at risk are those in situations of great promiscuity.
Shigella sonnei infections are commonly characterised by intermediate diarrhoea and fever, following a short period of incubation. Only culture of the faeces permits the diagnosis.
Confronted with an isolated case, treatment can only be initiated after bacteriological diagnosis. Confronted with symptomatic cases with at least one confirmed bacteriologically, treatment can be initiated without waiting for the results of the faecal culture.
Azithromycine has become the treatment of choice. Ceftriaxone, administered via the parenteral route, can hardly be considered as the first-line treatment. Quinolones can only be considered in last intention; only ciprofloxacine can be recommended.
Ciprofloxacine and ofloxacine can be recommended first-line over a period of 3 days.


CONCLUSIONS
A summary, including good faecal culture practices, can be found on the Website of the French Agency for the saitary of health products (Afssaps) (www.afssaps.sante.fr).
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D024901:Drug Resistance, Multiple, Bacterial; D004405:Dysentery, Bacillary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000635:transmission; D024841:Fluoroquinolones / Q000627:therapeutic use; D005759:Gastroenteritis / Q000188:drug therapy* / Q000382:microbiology*; D006801:Humans; D012764:Shigella sonnei
D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones