Control and Treatment

Sanitary measures are crucial for the prevention of bacillary dysentery and other diseases that are spread by fecal-oral route. Proper waste disposal, postdefecation handwashing, and safe water supplies are essential. Chlorination of water kills Shigella and other bacterial agents of dysentery. Sanitary food preparation, control of flies, and pasteurization of milk are also important. In areas with inadequate sanitation, avoidance of raw foods and use of bottled water can help to protect the traveler.

Patients may require rehydration and replacement of lost electrolytes, as well as symptomatic care for cramps and discomfort. Bed rest is important. After a day or two of fasting, soft, easily digestible food should be given in small, frequent meals. In most cases, such supportive therapy is sufficient. A variety of antibiotics can be effective against various Shigella species, but drug resistance is a growing problem. Many strains of S. sonnei in the United States have developed resistance to ampicillin and tetracycline; thus, in cases where drug therapy is essential, newer agents must be employed.

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