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Antimicrobial Therapy in Patients With Escherichia coli O157:H7 Infection
Kåre Mølbak, MD, DMSc;
Paul S. Mead, MD, MPH;
Patricia M. Griffin, MD
JAMA. 2002;288:1014-1016.
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Shiga toxin–producing Escherichia coli O157:H7 is an important cause of enteric illness in developed countries.1 Infection typically presents as a diarrheal illness, often with bloody stools. In approximately 8% of patients,2 infection progresses to hemolytic uremic syndrome (HUS), a life-threatening condition characterized by microangiopathic hemolytic anemia, thrombocytopenia, and renal failure.
The use of antimicrobial agents in the management of patients with E coli O157:H7 infection is controversial. Most strains are susceptible to commonly used antimicrobial agents3; however, these agents have not been shown to reduce the duration of diarrhea.4-6 More important, researchers are currently debating whether antimicrobial therapy increases or decreases the risk of developing HUS. In the production of HUS, Shiga toxins are key virulence factors, and the synthesis of this toxin appears to be regulated through the induction of an integrated bacteriophage that encodes . . . [Full Text of this Article]
Author Affiliations: Statens Serum Institut, Copenhagen, Denmark (Dr Mølbak); and the Centers for Disease Control and Prevention, Atlanta, Ga (Drs Mead and Griffin).
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