# Shigellosis antibiotics show 96% resistance in Kerala, doctors warn of AMR crisis 2026-08-24T08:15:31+00:00 | Governance | Indian Opinion Desk Corroboration: 1 independent outlet Kerala’s antimicrobial resistance surveillance network, KARS-NET, reports that Ciprofloxacin, the primary antibiotic for Shigellosis, now has a 96% resistance rate, rendering it ineffective. Resistance to the next-line drug Ceftriaxone has also risen to 36%, forcing doctors to use last-resort antibiotics like Meropenem for severe cases. The state saw a major Shigellosis outbreak in June 2024 with 225 cases and six deaths in Kozhikode, Malappuram and Wayanad districts, with clinicians suspecting AMR contributed to the unusually high fatality rate. Most acute diarrhoeal diseases are self-limiting and don't require antibiotics, but Shigellosis in children under five and the elderly can cause severe dehydration, sepsis and neurological complications requiring urgent treatment. R. Aravind, head of infectious diseases at Government Medical College Thiruvananthapuram and convener of KARS-NET, warned that community-acquired AMR is now at people's doorstep, shrinking the arsenal of effective antibiotics. A 2018 study in Alappuzha had already found 91.6% of Shigella isolates were multidrug resistant and ESBL-producing strains were emerging. Doctors stress that for patients with septic shock and multiorgan failure, the correct antibiotic must be administered within an hour and be 100% sensitive. Rising resistance means more treatment failures, longer hospital stays, higher costs and greater risk of new drug-resistant pathogens emerging in the community. A senior health official called this a wake-up call for careful antibiotic use. ## Indian Opinion Analysis Kerala’s KARS-NET has been tracking antimicrobial resistance for years, but Shigellosis data highlight a shift: resistance is now rising in community-acquired infections, not just hospitals. The 96% ciprofloxacin resistance rate means first-line treatment is essentially useless, forcing clinicians toward carbapenems like Meropenem, last-resort drugs that are costlier and increase risk of creating pan-resistant pathogens. The June outbreak, with 225 cases and six deaths in three northern districts, showed unusually high mortality, doctors suspect AMR played a role, though direct evidence is lacking. ESBL-producing Shigella strains were first documented in Kerala over a decade ago, as early as the 2011-2016 Alappuzha study, which reported 91.6% multidrug resistance. With community-level AMR now visible, the state’s health department faces pressure to tighten antibiotic prescription protocols, especially for diarrhoeal diseases where most cases don’t need antibiotics at all. The next signal to watch: whether the National Health Mission updates its Shigella treatment guidelines, given ciprofloxacin’s failure rate. ## Coverage - thehindu.com Leads with government surveillance data from KARS-NET and a government official's quote, neutral framing on facts This story was synthesised by AI from the source linked above. Tags: Government Medical College Thiruvananthapuram, Kerala, R. Aravind, Shigellosis Canonical: https://indianopinion.org/shigellosis-antibiotics-show-96-resistance-in-kerala-doctors-warn-of-amr-crisis/ License: Summary and commentary (c) Indian Opinion, reusable with attribution. Facts belong to the linked sources. Cite: https://indianopinion.org/shigellosis-antibiotics-show-96-resistance-in-kerala-doctors-warn-of-amr-crisis/#story-in-brief Review state: restored archive article, accurate at time of publication, not offered to search indexes. How this brief was made: an AI model read the report linked above and wrote this summary and analysis, which were published automatically. Published briefs are sampled every hour by an automated quality check; the editor verifies its findings and approves corrections, and corrected briefs carry a dated correction line. We do no original reporting. Methodology: https://indianopinion.org/ai-use-policy/