Remarks — This recommendation was informed by a previous Cochrane Review (73) on antibiotics in Shigelladysentery. — The dosage and duration of the first- and second-line antibiotics are according to the existing recommendation (first line: Ciprofloxacin: 15 mg/kg per dose twice daily for three days; second line: Ceftriaxone:50–80 mg/kg daily for three days) (13). — The GDG was advised by the methodologists on the discordant recommendation which was made on this subject in the previous guideline. The panel was asked to justify the discordant recommendation taking into account the low certainty of evidence. In response, the GDG maintained a discordant recommendation because it noted that there is a potential for catastrophic harm if children are not treated immediately when they present with dysentery. An example was given of an observational study (unpublished, so not included in the review) carried out during the conflict in Rwanda in 1994 where children in one group who had Shigella dysentery were not given antibiotics immediately. The outcomes in this group were considerably worse than in the group which received antibiotics. — The GDG again noted, as in the previous recommendation, that health workers should refer to local sensitivity patterns of antibiotics, and the attention of policy-makers is drawn to WHO’s AWARE watch list for other issues about antibiotic stewardship (62).