American Board of Internal Medicine (ABIM) Certification Practice Exam

How should quinolone-resistant Shigella species be treated?

1. Use high-dose ciprofloxacin

2. Switch to ampicillin

3. Apply supportive care only

4. Utilize alternative therapies

The correct answer is: Utilize alternative therapies

Quinolone-resistant Shigella species present a significant challenge in treatment due to their resistance to standard antibiotic therapies like ciprofloxacin. When faced with such resistance, healthcare providers must seek alternative therapies that are effective against these resistant strains. The choice of alternative therapies may include options such as azithromycin or ceftriaxone, which have proven efficacy in treating shigellosis caused by resistant Shigella. The use of these alternative antibiotics is crucial for ensuring patient recovery and preventing the spread of resistant bacteria. High-dose ciprofloxacin would not be appropriate since the resistance indicates that the drug will likely be ineffective. Similarly, switching to ampicillin is not advisable as many Shigella species, particularly those that are quinolone-resistant, may also demonstrate resistance to ampicillin. Supportive care might be an important part of the management plan, but it is insufficient as a standalone treatment for a bacterial infection. Therefore, utilizing alternative therapies is the most suitable approach for effectively managing infections caused by quinolone-resistant Shigella species.