Acute diarrhea (AD) is one of the leading causes of child mortality, particularly in children under 5 years old. Dysentery, a severe form of AD characterized by blood and mucus in the stool, raises controversies regarding the appropriate use of antibiotics. The objective of this manuscript is to synthesize the available information on the indications, risks, and benefits of antibiotics used in infectious dysentery during early childhood. A scoping systematic review was conducted using international reference documents and the databases PubMed, Scopus, and Google Scholar, following the PRISMA-ScR guidelines. Studies from 2014 onwards that addressed antibiotic management in children under 5 years old with bacterial or parasitic dysentery were included. Among the 39 selected studies, the evidence shows limited benefits and significant risks associated with antibiotic use, with recommendations varying based on specific etiology and the patient's clinical conditions, where it is evident that the rational use of antibiotics in pediatric dysentery is crucial to avoid bacterial resistance and adverse effects. There is a need for future research to establish guidelines based on robust clinical trials, to optimize targeted treatment and improve clinical outcomes in this population.
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