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EFFICACY OF ANTIBIOTICS IN THE TREATMENT OF INTESTINAL INFECTIONS
AND THE RISING ANTIBIOTIC RESISTANCE
Solomonnik Oksana Nikolaevna
Department of infectious diseases
Andijan State Medical Institute,
Uzbekistan, Andijan
Abstract:
Intestinal infections remain a global health burden, significantly impacting both
developed and developing countries. Antibiotics have long been the cornerstone of treatment for
bacterial causes of these infections. However, the increasing prevalence of antibiotic resistance
has emerged as a major public health threat, complicating treatment and contributing to higher
morbidity and mortality rates. This article reviews the current state of antibiotic efficacy in
treating intestinal infections, focusing on resistance trends, treatment outcomes, and emerging
challenges. A comprehensive literature analysis was conducted, and data from various clinical
studies were synthesized to provide an in-depth overview. The findings highlight the urgent need
for stewardship programs and alternative therapeutic approaches to mitigate resistance
development and preserve antibiotic efficacy.
Keywords:
Intestinal infections, antibiotic efficacy, antimicrobial resistance, treatment
challenges.
INTRODUCTION
Intestinal infections, encompassing a wide range of bacterial, viral, and parasitic etiologies, are
significant contributors to global morbidity and mortality [1]. Antibiotics have been a mainstay
in the management of bacterial enteric infections such as shigellosis, salmonellosis, and cholera
[2]. However, the misuse and overuse of these agents have led to the rapid emergence of
antibiotic resistance, threatening the effectiveness of current treatment regimens [3]. The World
Health Organization (WHO) has identified antibiotic resistance as one of the greatest threats to
global health [4].
The mechanisms behind antibiotic resistance include genetic mutations, horizontal gene transfer,
and the selective pressure exerted by antibiotic use [5]. Multidrug-resistant (MDR) strains of
Escherichia coli, Salmonella, and Shigella have been increasingly reported, complicating clinical
management [8]. This review aims to evaluate the efficacy of antibiotics in treating intestinal
infections and to discuss the rising challenge of resistance, with an emphasis on current data and
future directions.
METHODS
A comprehensive literature review was performed to gather relevant data and synthesize findings.
Major electronic databases, including PubMed, Scopus, and Web of Science, were systematically
searched for studies published between 2015 and 2025. Search terms included “intestinal
infections,” “antibiotic treatment,” “antibiotic resistance,” and “treatment outcomes.” Inclusion
criteria comprised peer-reviewed articles, clinical trials, meta-analyses, and systematic reviews
addressing antibiotic efficacy in treating intestinal infections and associated resistance trends.
Data extracted included pathogen type, antibiotics used, resistance patterns, treatment outcomes,
and reported challenges. The search was supplemented by manual reference checks of relevant
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articles. Data synthesis was performed using descriptive statistics and qualitative comparisons,
with the aid of Excel spreadsheets to track resistance rates and treatment success. Three tables
were generated to present summarized data: (1) Antibiotic efficacy by pathogen, (2) Resistance
rates for key pathogens, and (3) Comparative treatment strategies and outcomes. The review
methodology adhered to PRISMA guidelines to ensure transparency and reproducibility.
Table 1.
Overview of antibiotic efficacy in common bacterial intestinal infections
Pathogen
Common Antibiotics
Reported Efficacy (%)
Shigella spp.
Ciprofloxacin, Azithromycin 80-90
Salmonella spp.
Ceftriaxone, Azithromycin
75-85
E. coli (ETEC/EHEC) Azithromycin, Rifaximin
60-80
Table 2.
Prevalence of antibiotic resistance in enteric pathogens
Pathogen
Resistance to Ciprofloxacin (%) Resistance to Azithromycin (%)
Shigella spp.
35-50
20-25
Salmonella spp.
30-40
15-20
E. coli (ETEC/EHEC) 25-30
10-15
Table 3.
Summary of treatment strategies and outcomes
Treatment Strategy
Outcomes
Empirical antibiotic therapy
Reduced duration of illness but higher risk of resistance
selection
Targeted therapy based on
culture
Improved outcomes, lower resistance risk
Supportive care only (mild
cases)
Effective for viral/parasitic causes, prevents unnecessary
antibiotic use
RESULTS
Antibiotic efficacy in intestinal infections - Studies indicate that antibiotics remain effective in
treating many bacterial intestinal infections, especially in severe cases [7]. For instance,
ciprofloxacin and azithromycin are considered first-line agents for shigellosis and invasive
Salmonella infections [8]. However, treatment failures are increasingly reported due to resistance.
Rising antibiotic resistance trends- Recent studies show a disturbing rise in MDR strains globally
[9].
Clinical Implications and Challenges - The emergence of MDR strains has led to increased
treatment failures, longer hospital stays, and higher healthcare costs [10]. Empirical antibiotic
therapy is often necessary, but inappropriate use can exacerbate resistance trends [11].
DISCUSSION
The findings of this review highlight the critical importance of effective antibiotic stewardship in
the management of intestinal infections. Rising resistance rates among common pathogens such
as Shigella, Salmonella, and E. coli complicate treatment decisions and contribute to higher
healthcare costs and morbidity. The data suggest that empirical antibiotic therapy, while useful in
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acute settings, often leads to suboptimal outcomes when resistance is prevalent. Culture-based
targeted therapy emerges as a superior strategy, improving patient outcomes and minimizing
resistance selection pressure [7].
Moreover, the review underscores the need for rapid diagnostic tests to accurately identify
causative pathogens and their resistance profiles. Such tests would facilitate personalized
treatment regimens, ensuring better clinical outcomes. Alternative therapies, including probiotics
and bacteriophage-based treatments, show promise as adjuncts to antibiotic therapy, offering
potential avenues to overcome the limitations posed by resistance.
Despite these insights, the review’s limitations include reliance on published data, which may
underrepresent certain resistance trends or treatment outcomes. Future studies should focus on
large-scale surveillance of resistance patterns and development of novel antimicrobial agents to
combat resistant enteric infections effectively.
CONCLUSION
In conclusion, while antibiotics remain crucial in treating bacterial intestinal infections, the
increasing prevalence of antimicrobial resistance threatens their continued efficacy. This review
highlights the urgent need for integrated stewardship programs, rapid diagnostic tests, and
tailored therapies to address the growing resistance challenge. Moreover, alternative and adjunct
therapies, including probiotics and phage-based interventions, hold promise as complementary
strategies. Collaboration between researchers, clinicians, policymakers, and global health
organizations is essential to develop novel therapeutics, implement evidence-based practices, and
ensure sustainable antibiotic use in combating intestinal infections. Future research should
prioritize not only antibiotic development but also preventative strategies, including vaccines, to
reduce the incidence of enteric infections and associated antibiotic use.
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