Systematic review: are antibiotics detrimental or beneficial for the treatment of patients with <i>Escherichia coli</i> O157:H7 infection?

Panos, George; Betsi, Gregoria I.; Falagas, M.E.

doi:10.1111/j.1365-2036.2006.03036.x

Cited by 97 publications

(63 citation statements)

References 67 publications

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“…Currently, there is no vaccine available to humans to prevent infection by EPEC or EHEC, and the use of antibiotics for treatment of EHEC infections is controversial as certain antibiotics may exacerbate disease symptoms (Panos et al 2006), as well as induce Shiga toxin production. Numerous EHEC outbreaks have been traced back to ingestion of contaminated beef and vegetable products (Nataro and Kaper 1998;Berger et al 2010).…”

Section: Epec Infection Modelsmentioning

confidence: 99%

In Vitro and In Vivo Model Systems for Studying Enteropathogenic Escherichia coli Infections

Law

Gur-Arie

Rosenshine

et al. 2013

Cold Spring Harbor Perspectives in Medicine

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Enteropathogenic Escherichia coli (EPEC) and enterohemorrhagic E. coli (EHEC) belong to a group of bacteria known as attaching and effacing (A/E) pathogens that cause disease by adhering to the lumenal surfaces of their host's intestinal epithelium. EPEC and EHEC are major causes of infectious diarrhea that result in significant childhood morbidity and mortality worldwide. Recent advances in in vitro and in vivo modeling of these pathogens have contributed to our knowledge of how EPEC and EHEC attach to host cells and subvert hostcell signaling pathways to promote infection and cause disease. A more detailed understanding of how these pathogenic microbes infect their hosts and how the host responds to infection could ultimately lead to new therapeutic strategies to help control these significant enteric pathogens.

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Section: Epec Infection Modelsmentioning

confidence: 99%

In Vitro and In Vivo Model Systems for Studying Enteropathogenic Escherichia coli Infections

Law

Gur-Arie

Rosenshine

et al. 2013

Cold Spring Harbor Perspectives in Medicine

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“…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. [55][56][57] Most studies found no difference or favored a negative impact of antibiotics on risk for D+HUS and outcome. 55,56 Only one retrospective cohort analysis of a large outbreak that occurred in Japan, demonstrated benefit for using the antibiotic fosfomycin within the first 2-3 days from beginning of EHEC infection symptoms.…”

mentioning

confidence: 99%

“…[55][56][57] Most studies found no difference or favored a negative impact of antibiotics on risk for D+HUS and outcome. 55,56 Only one retrospective cohort analysis of a large outbreak that occurred in Japan, demonstrated benefit for using the antibiotic fosfomycin within the first 2-3 days from beginning of EHEC infection symptoms. 50,58 The negative impact of antibiotic use on risk and outcomes of HUS is not well understood.…”

mentioning

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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“…Two systematic reviews [4,5] assessing HUS risk after antibiotic antibiotic administration to STEC-infected patients concluded that they neither decreased nor increased the likelihood of this complication. The first meta-analysis reported a pooled odds ratio (OR) of 1.15 (95% confidence interval [CI], .79-1.68), but had methodological limitations.…”

mentioning

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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Systematic review: are antibiotics detrimental or beneficial for the treatment of patients with Escherichia coli O157:H7 infection?

Abstract: SUMMARY BackgroundEscherichia coli O157:H7 is a foodborne pathogen causing haemorrhagic colitis, which is sometimes complicated by haemolytic uraemic syndrome or thrombotic thrombocytopenic purpura.

Cited by 97 publications

References 67 publications

In Vitro and In Vivo Model Systems for Studying Enteropathogenic Escherichia coli Infections

In Vitro and In Vivo Model Systems for Studying Enteropathogenic Escherichia coli Infections

Management of hemolytic-uremic syndrome in children

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

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