Antibiotics for Clinical Dysentery in the Pediatric Emergency Department

Background: Clinical dysentery causes hundreds of thousands of deaths annually worldwide. However, current recommenda-tions reserve antibiotics for those either clinically sick or with highly suspected cases of shigellosis. This treatment stems from rising antibiotic resistance. Children diagnosed with clin-ical dysentery in the pediatric emergency department (PED) are regarded more cautiously.Objectives: To explore the use of antibiotics in children diag-nosed with clinical dysentery in the PED.Methods: A retrospective case study of children with clinical dysentery at a single PED during the years 2015 and 2018. Demographics as weil as clinical findings were compared to culture results and antibiotic treatment.Results: The study included 281 children who were diagnosed with clinical dysentery during the study period; 234 (83%) were treated with antibiotics. However, cultures were positive in only 162 cases (58%). Only 32% were Shigella spp. Younger age, fever, and leukocytosis were related to antibiotic treat-ment.Conclusions: The diagnosis of clinical dysentery is misgiven commonly in the PED leading to widespread use of antibiotics when not indicated. This treatment may impact antibiotic re-sistance patterns. Further studies and interventions are nec-essary to create clear guidelines in the PED setting..