6 Scopus citations

Abstract

Purpose of reviewThere has been much debate about treating Shiga toxin-producing Escherichia coli (STEC) infections with antibiotics. No data convincingly demonstrate that antibiotics are better than no antibiotic treatment at all, and many studies suggest antibiotics increase the risk of developing the hemolytic uremic syndrome (HUS). This topic is timely, because emerging technology enables rapid identification of STEC-infected patients, and we anticipate questions about management will increase. This review is designed to familiarize readers with the series of observations that underlie our recommendations.Recent findingsThe long debate over antibiotics in STEC infections appears resolved by gradually accruing information that show that antibiotics do not benefit infected patients. In fact, they are associated with an increased likelihood of developing HUS. A meta-analysis published in 2016 demonstrated that low risk of bias studies find a clear association between antibiotic use and development of HUS. Subsequent publications do not refute these findings.SummaryIn high-income countries, antibiotics should not routinely be given to patients with acute diarrhea unless testing demonstrates a pathogen for which antibiotics are indicated, and STEC infection has been excluded. Future work to prevent HUS should focus on preventing primary infections, and mitigating extraintestinal consequences of STEC gut infections.

Original languageEnglish
Pages (from-to)30-38
Number of pages9
JournalCurrent opinion in gastroenterology
Volume38
Issue number1
DOIs
StatePublished - Jan 1 2022

Keywords

  • Antibiotics
  • Bloody diarrhea
  • Escherichia coli O157 H7
  • Hemolytic uremic syndrome
  • Shiga toxin-producing Escherichia coli

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