• Yehonatan Azulai, Shepard Schwartz, Eyal Heiman, Elihay Berliner, and Giora Weiser.
• Faculty of Medicine, Hebrew University of Jerusalem, Israel.
• Isr Med Assoc J. 2023 Jan 1; 25 (1): 575-7.

BackgroundClinical dysentery causes hundreds of thousands of deaths annually worldwide. However, current recommendations reserve antibiotics for those either clinically sick or with highly suspected cases of shigellosis. This treatment stems from rising antibiotic resistance. Children diagnosed with clinical dysentery in the pediatric emergency department (PED) are regarded more cautiously.ObjectivesTo explore the use of antibiotics in children diagnosed with clinical dysentery in the PED.MethodsA retrospective case study of children with clinical dysentery at a single PED during the years 2015 and 2018. Demographics as well as clinical findings were compared to culture results and antibiotic treatment.ResultsThe 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 treatment.ConclusionsThe diagnosis of clinical dysentery is misgiven commonly in the PED leading to widespread use of antibiotics when not indicated. This treatment may impact antibiotic resistance patterns. Further studies and interventions are necessary to create clear guidelines in the PED setting.

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