Antibiotics and E. coli
The information below about antibiotics and E. coli infections is not medical advice. We are a law firm that represents E. coli victims throughout the United States. We are publishing this information as a public service because we want to prevent hemolytic uremic syndrome, a severe illness caused by an E. coli infection.
Antibiotics
If you have an E. coli O157:H7 infection, the CDC recommends that you DO NOT TAKE ANTIBIOTICS. According to the CDC, few, if any, positive effects of antibiotics have been shown on Shiga toxin-producing E. coli (STEC) infections. In fact, some antibiotics have been found to increase the duration and severity of associated diarrhea (1,2). Antibiotics have also been implicated as a contributing factor for the development of a potentially lethal complication called hemolytic uremic syndrome (HUS), especially in children. A study by Wong et al. found that in a group of 71 children infected with E. coli O157:H7, 10 developed HUS (3). Of those 10, 5 had been given antibiotics; only 9 children overall were given antibiotics.
After a 1996 outbreak in Japan, researchers there concluded that certain rapidly administered oral quinolones may be beneficial and decrease risk of developing HUS (3.7%) (4). They also found that treatment with intravenous cephalosporin greatly increased the chances of developing HUS (18.2%). However, these results were not compared to a control group that was not given any antibiotics; they were only compared to treatment with other antibiotics. Further research is needed to determine if orally-administered quinolones truly are better than no antibiotic treatment.
Antimotility Drugs
Severe abdominal pain typically accompanies E. coli O157:H7 infections, and one may be tempted to take pain medication. Typical medications used with abdominal pain–antimotility drugs, anticholinergic agents, and opioid narcotic–relax the muscles of the digestive tract, which can relieve cramping pain and increase water absorption resulting in less watery stools. However, relaxation of the muscles controlling the intestines also allows the pathogen and associated toxins to be further absorbed and can result in longer and more severe bloody diarrhea (5). A study by Bell et al. found that children treated with antimotility agents had approximately a 2 times greater risk for developing HUS (6). According to this study, common antimotility agents to avoid would include loperamide (Imodium®) and dephnoxylate (Lomotil®).
Sources
1. Pavia A., Nichols C., Green D., et al. 1990. Hemolytic-uremic syndrome during an outbreak of Escherichia coli O157:H7 infections in institutions for mentally retarded persons: clinical and epidemiologic observations. J Pediatr. 116: 544–51.
2. Ostroff S, Kobayashi J, Lewis J. 1989. Infections with Escherichia coli O157:H7 in Washington State. The first year of statewide disease surveillance. JAMA, 262: 355–9.
3. Wong C, Jelacic S, Habeeb R, et al. 2000. The risk of the hemolytic-uremic syndrome after antibiotic treatment of Escherichia coli O157:H7 infections. N Engl J Med, 342: 1930–6.
4. Shiomi M, Togawa M, Fujita K, et al. 1999. Effect of early oral fluoroquinolones in hemorrhagic colitis due to Escherichia coli O157:H7. Pediatr Int. 4: 228–32.
5 Pfeiffer J, Nicotra D. APIC test of infection control and epidemiology. 2000. Washington, DC: Association for Professionals in Infection Control and Epidemiology, Inc. (APIC)
6. Bell B, Griffin P, Lozano P, et al. 1997. Predictors of hemolytic uremic syndrome in children during a large outbreak of Escherichia coli O157:H7 infections. Pediatrics. 100: E12.
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