jueves, 26 de julio de 2012

European E. coli Outbreak Sheds New Light on Treatment Strategies

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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