Antibiotic Treatment of Escherichia coli O157 Infection and the Risk of Hemolytic Uremic Syndrome, Minnesota

Smith, Kirk E.; Wilker, Peter R.; Reiter, Paul L.; Hedican, Erin B.; Bender, Jeffrey B.; Hedberg, Craig W.

doi:10.1097/inf.0b013e31823096a8

Cited by 131 publications

(95 citation statements)

References 24 publications

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“…21 In this study, more than a fifth of the respondents use antibiotics indiscriminately in the treatment of diarrhoea which may be dangerous as some cases of enteroheamorrhagic Escherichia coli infection have been associated with increased risk of the development of haemolytic uremic syndrome after indiscriminate antibiotic treatment. [22][23] this study revealed that 72.4% of respondents use same antibiotics as previously prescribed by their doctor to treat their perceived infections. Self medication with antibiotics is defined as the acquisition and selfadministration of antibiotics with the aim of treating a perceived infection.…”

Section: Resultsmentioning

confidence: 99%

Knowledge and practices in the use of antibiotics among a group of Nigerian university students

Igbeneghu

2013

Int. j. infect. control

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the study examined the knowledge and practice of antibiotic use among students in a university in south western Nigeria. A questionnaire was administered to each of 500 students drawn from all the Departments in the university excluding those from the faculty of Pharmacy, Health Sciences and Department of Microbiology. A response rate of 99.2% was obtained from the respondents. the most commonly used antibiotics were tetracycline and amoxicillin. Antibiotic use for common cold was observed in 32.3% of the respondents while 17.7% used antibiotics for sore throat. Majority of the participants (72.4%) used the same antibiotics as previously prescribed by their doctors to treat their perceived infections while 51.2% kept left over antibiotics with the intention of future use. More than half (55%) of the students stopped taking their antibiotics when they felt better or when the symptoms of their infections appeared to have stopped. the students' rating of their sources of antibiotics and prescription for antibiotics indicated that most of the students do not know the appropriate sources from where to purchase their antibiotics nor do they know the appropriate persons from whom to obtain a prescription for antibiotics. the study showed a high rate of consumption of antibiotics among university undergraduates who mostly obtain their antibiotics without a physician's prescription from unofficial sources and do not complete their course of antibiotic therapy. these students need better education on the appropriate use of antibiotics in order to improve their attitude towards antibiotics.

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Section: Resultsmentioning

confidence: 99%

Knowledge and practices in the use of antibiotics among a group of Nigerian university students

Igbeneghu

2013

Int. j. infect. control

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“…Piercefield et al used admission white blood cell count >20 000 cells/µL as a proxy for illness severity; however, adjustment did not change their results (adjusted values not provided) [20]. Smith et al adjusted for vomiting, fever, bloody diarrhea, and sex [25]. This minimally changed the ORs (1.…”

Section: Qualitative Review Of Results Adjusting For Covariatesmentioning

confidence: 99%

“…Although the lack of detail relating exposures to outcomes at a patient level limited some of our subanalyses, we did explore the relationships between country and acquisition (ie, outbreak vs sporadic). We additionally explored antibiotic class as a risk factor in our meta-analysis; no antibiotic/antibiotic class emerged as protective from the development of HUS, compared with nontreatment [25,27]. Although there are intra-and interserotype differences in the release of Shiga toxin from STEC after exposure to antibiotics in vitro [43], the decision to treat must be made at the time of initial presentation; hence, the variable release of toxin by an infecting strain cannot, for the foreseeable future, be entered into clinical decisions.…”

Section: Discussionmentioning

confidence: 99%

Shiga Toxin–ProducingEscherichia coliInfection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis

et al. 2016

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Background. Antibiotic administration to individuals with Shiga toxin-producing Escherichia coli (STEC) infection remains controversial. We assessed if antibiotic administration to individuals with STEC infection is associated with development of hemolytic uremic syndrome (HUS).Methods. The analysis included studies published up to 29 April 2015, that provided data from patients (1) with STEC infection, (2) who received antibiotics, (3) who developed HUS, and (4) for whom data reported timing of antibiotic administration in relation to HUS. Risk of bias was assessed; strength of evidence was adjudicated. HUS was the primary outcome. Secondary outcomes restricted the analysis to low-risk-of-bias studies employing commonly used HUS criteria. Pooled estimates of the odds ratio (OR) were obtained using random-effects models.Results. Seventeen reports and 1896 patients met eligibility; 8 (47%) studies were retrospective, 5 (29%) were prospective cohort, 3 (18%) were case-control, and 1 was a trial. The pooled OR, including all studies, associating antibiotic administration and development of HUS was 1.33 (95% confidence interval [CI], .89-1.99; I 2 = 42%). The repeat analysis including only studies with a low risk of bias and those employing an appropriate definition of HUS yielded an OR of 2.24 (95% CI, 1.45-3.46; I 2 = 0%).Conclusions. Overall, use of antibiotics was not associated with an increased risk of developing HUS; however, after excluding studies at high risk of bias and those that did not employ an acceptable definition of HUS, there was a significant association. Consequently, the use of antibiotics in individuals with STEC infections is not recommended.

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“…However, most available data were obtained from retrospective and some prospective cohort studies demonstrating conflicting results. 5,9,13,[49][50][51][52][53][54] Prospective, blinded, and randomized studies have not been conducted, and observational studies have been affected by bias toward use of antibiotics in initially "sicker" patients. A number of metaanalyses and systematic reviews have attempted to summarize the results of available studies, reaching inconclusive results and stating that more prospective, appropriately powered studies are needed.…”

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confidence: 99%

Management of hemolytic-uremic syndrome in children

Grisaru¹

2014

IJNRD

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Acute renal failure associated with a fulminant, life-threatening systemic disease is rare in previously healthy young children; however, when it occurs, the most common cause is hemolytic-uremic syndrome (HUS). In most cases (90%), this abrupt and devastating illness is a result of ingestion of food or drink contaminated with pathogens that produce very potent toxins. Currently, there are no proven treatment options that can directly inactivate the toxin or effectively interfere with the cascade of destructive events triggered by the toxin once it gains access to the bloodstream and binds its receptor. However, HUS is self-limited, and effective supportive management during the acute phase is proven to be a life saver for children affected by HUS. A minority of childhood HUS cases, approximately 5%, are caused by various genetic mutations causing uncontrolled activation of the complement system. These children, who used to have a poor prognosis leading to end-stage renal disease, now have access to exciting new treatment options that can preserve kidney function and avoid disease recurrences. This review provides a summary of the current knowledge on the epidemiology, pathophysiology, and clinical presentation of childhood HUS, focusing on a practical approach to best management measures.

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Antibiotic Treatment of Escherichia coli O157 Infection and the Risk of Hemolytic Uremic Syndrome, Minnesota

Abstract: Individuals infected with O157 infection presenting with a more severe illness were at an increased risk of developing HUS. The use of bactericidal antibiotics, particularly β-lactams, to treat O157 infection was associated with the subsequent development of HUS.

Cited by 131 publications

References 24 publications

Knowledge and practices in the use of antibiotics among a group of Nigerian university students

Knowledge and practices in the use of antibiotics among a group of Nigerian university students

Shiga Toxin–ProducingEscherichia coliInfection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis

Management of hemolytic-uremic syndrome in children

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