ROSH Gastrointestinal Practice Exam

Following travel, a woman presents with symptoms consistent with Shigella infection. Which treatment is recommended?

1. Ciprofloxacin

2. Lactulose

3. Sulfasalazine

4. Tenofovir

The correct answer is: Ciprofloxacin

Ciprofloxacin is recommended for treating Shigella infections, particularly in travelers who have contracted this type of bacterial gastroenteritis. Shigella species are known to cause dysentery, characterized by diarrhea that can be bloody, abdominal cramps, and fever. Fluoroquinolones such as ciprofloxacin are effective due to their ability to inhibit bacterial DNA gyrase, leading to the cessation of bacterial replication and eventually to the death of the organism. Ciprofloxacin is particularly advantageous in this scenario because it has a well-established efficacy profile against Shigella, and in settings of travel-related infections, the risk of antibiotic resistance is generally lower for this medication compared to others. The quick onset of action and relatively good gastrointestinal absorption make it a preferred choice for patients exhibiting symptomatic bacterial gastroenteritis after travel. Other treatments listed, such as lactulose and sulfasalazine, are not indicated for Shigella infections. Lactulose is typically used for managing constipation or hepatic encephalopathy, while sulfasalazine is primarily used in inflammatory bowel disease, not bacterial infections. Tenofovir is an antiviral medication used mainly in the treatment of HIV and hepatitis B, making it irrelevant in the context of a bacterial infection caused by Shig