Antibiotic drugs are harmful, not beneficial, to HUS patients.
It is an accepted fact among medical experts that an E. coli infection should not be treated with antibiotics, as these drugs may worsen illness. But a new review of strategies used to treat victims of last year's European enterohemorrhagic E. coli outbreak shows that a combination of two or more antibiotics may have helped patients recover from hemolytic uremic syndrome (HUS) - a potentially fatal complication of E. coli infection.
The 2011
outbreak, centered in Northern Germany, was characterized by an unusually high
number of HUS cases. Out of more than 4,000 people sickened by the E. coli O104:H4 bacteria, 22 percent
developed this life-threatening condition. By contrast, E. coli O157:H7, the most common Shiga toxin-producing E. coli (STEC) in the United States
progresses into HUS in 5 to 10 percent of patients.
Antibiotics
are thought to increase a patient's chance of developing HUS by increasing
bacterial death and triggering the release of more Shiga toxins. But a study
published this recently in BMJ suggests that some antibiotics may actually help
treat the kidney disease.
Scientists
reviewed 298 cases of HUS treated at 23 hospitals in Northern Germany during
the 2011 outbreak, finding that patients treated with at least two antibiotics
were less likely to experience seizures, did not require intestinal surgery and
exhibited no signs of toxic shock. The death rate among these individuals was
lower than among other patients.
The two
antibiotics used most commonly were meropenem
and ciprofloxacin. Rifaximin was given to patients in the
intensive care unit. All of these drugs were administered at only one hospital
included in the study. Other treatment centers did not use antibiotics.
Researchers
also found that stool samples from these patients tested negative for the
bacteria an average of 8 days before those of other patients.
These findings
are similar to those of a previous study which found that the antibiotic azithromycin also shortened the time
that individuals shed E. coli O104:H4
after infection.
Research on
the effect of antibiotics on individuals with E. coli O157:H7 infections, on the other hand, have overwhelmingly
suggested that these drugs are harmful, not beneficial, to HUS patients. A
study from the Washington University Medical Center in St. Louis published in
March found that children who were administered antibiotics while infected with
E. coli O157:H7 were more likely to
develop HUS.
Aporte: Dalia Clarisa
Echeverry Moreno
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