What are the recommended antibiotic treatments for Shigella and amoebic dysentery in primary care settings?

Recommended antibiotic treatments for Shigella infection in primary care: Antibiotic treatment is generally reserved for severe cases or those with systemic symptoms. First-line treatment often includes ciprofloxacin; however, due to recent MHRA restrictions on fluoroquinolones, ciprofloxacin should only be prescribed when other antibiotics are inappropriate. Alternative antibiotics may include co-amoxiclav or cefalexin combined with metronidazole, depending on allergy status and local microbiology advice. Treatment duration is typically around 5 days. For amoebic dysentery: Metronidazole is the mainstay of treatment, usually given at 400-500 mg three times daily for 5 to 10 days. In cases of confirmed amoebic infection, metronidazole targets the protozoal cause effectively. Supportive care and rehydration are also important. Note: Specific guidance for Shigella and amoebic dysentery antibiotic regimens in primary care is not detailed in the provided NICE guidelines, but the use of metronidazole for protozoal infections and cautious use of ciprofloxacin for bacterial enteric infections aligns with general UK practice and MHRA safety advice on fluoroquinolones ¹,².