Escherichia coli O157:H7 is a foodborne pathogen causing hemorrhagic colitis.
This is sometimes complicated by hemolytic uremic syndrome or thrombotic thrombocytopenic purpura.
Dr Panos and colleagues from Greece reviewed the available evidence whether antibiotics are effective or harmful for treating E coli infection.
The research team searched in the PubMed for relevant laboratory and clinical studies published between 1982 and 2005.
The team noted that in vitro studies have shown that most E coli isolates are susceptible to various antibiotics.
| No clinical studies show that antibiotics reduce the duration of E coli infection|
|Alimentary Pharmacology & Therapeutics|
However, certain antibiotics, especially at sublethal concentrations, have been found to increase the release of Shiga-like toxins.
These toxins have been associated with the development of hemolytic uremic syndrome/thrombotic thrombocytopenic purpura in humans.
No clinical studies have indicated that antibiotics are effective in reducing the duration of E coli infection.
The team also found no clinical studies showing that antibiotics effectively reduce the duration of diarrhea or bloody diarrhea specifically.
Few studies have supported that some antibiotics, especially quinolones and fosfomycin, may prevent the development of hemolytic uremic syndrome.
The team noted few studies that showed antibiotics preventing thrombotic thrombocytopenic purpura.
On the other hand, the team observed that some clinical studies associate antibiotics with a higher risk for hemolytic uraemic syndrome.
These studies also associate antibiotics with a longer duration of diarrhea, even with high mortality.
Dr Panos' team concludes, “More randomized controlled trials are necessary in order to elucidate whether antibiotics are effective in reducing the morbidity and mortality of E coli infection, rather than having a detrimental effect.”