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December 10, 1973

Ampicillin-Resistant Shigella

Author Affiliations

Kansas City, Kan

JAMA. 1973;226(11):1359. doi:10.1001/jama.1973.03230110047020

To the Editor.—  Ampicillin has been recommended as the antibiotic of choice for the treatment of Shigella infections.1 However, the recent rise in incidence of ampicillin-resistant Shigella may be forcing clinicians to reevaluate the effectiveness of ampicillin.From January 1968 to July 1973, 211 strains of Shigella were isolated at the University of Kansas Medical Center, Kansas City. Of these isolates, 169 (80.1%) were S sonnei, and 42 (19.9%) S flexneri. Antibiotic sensitivity tests used the standard Kirby-Bauer disk technique. The results are summarized in the Table.From 1968 to 1973, a rapid increase in ampicillin-resistant Shigella from 0% to 85.3% (S sonnei from 0% to 87.5%, S flexneri from 0% to 66.6%) occurred in our hospital. A similar increase in the rates of resistance to tetracycline and streptomycin was also observed.Up to 1968, no strain of Shigella had been found resistant to ampicillin. However, in 1973 68%