PMID: 18181399Jan 10, 2008Paper

Death from multi-resistant shigelloses: a case study from Fiji

Pacific Health Dialog
Chris Watson

Abstract

Death from Shigellosis is rare in developed countries, however it causes over a million deaths in developing countries worldwide annually. Death from shigellosis is rare in Fiji. However, the global problem of emerging multi-drug resistance raises some issues about the management of Shigellosis in this country. Within Fiji, Shigella is a notifiable disease. The Fiji Ministry of Health recorded 68 cases of Shigella in 1996, 173 cases in 1997 and 334 cases in 1998 (no data available for 1999). There was only one recorded death during this time--in 1998. Resistance to chloramphenicol occurred in 82% of cases. Shigella flexneri in Fiji remains sensitive to cephalothin and cefaclor. The current antibiotic guidelines in Fiji, recommend that antibiotics be used only for cases of moderate and severe dysentery. Shigellosis was suspected soon after presentation however the patient was unable to take oral antibiotics and was treated with intravenous antibiotics (chloramphenicol and ampicillin), which were ineffective due to resistance of the organism. The current antibiotic guidelines for severe dysentry recommend chloramphenicol or nalidixic acid--the later not available in Fiji. However the only intravenous drugs that retain their sensi...Continue Reading

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