Issue: May 2012
March 21, 2012
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Azithromycin reduced long-term STEC infection

Nitschke M. JAMA. 2012;307:1046-1052.

Issue: May 2012
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Treatment with azithromycin was associated with a lower frequency of long-term Shiga toxin-producing enteroaggregative Escherichia coli, according to researchers from Germany.

For the study, researchers analyzed the duration of bacterial shedding among those who did and did not receive prophylactic azithromycin during the May 2011 Shiga toxin-producing E. coli (STEC) outbreak in Germany.

The cohort included 65 patients with STEC from one center in Germany. Patients presented from May 15 to July 26 and were monitored for a mean of 39.3 days after onset of clinical symptoms.

Twenty-two patients received azithromycin and the remaining 43 did not. Among those who received the antibiotic, long-term STEC carriage was observed in one patient compared with 35 patients who did not receive the antibiotic.

All of the 22 patients receiving azithromycin had at least three STEC-negative stool specimens after treatment. There was no recurrence of STEC observed among these patients. Among the 43 patients who did not initially receive azithromycin and who were long-term STEC carriers, 15 were treated with azithromycin for 3 days and, subsequently, had negative stool specimens.

"Our findings suggest that among patients with STEC infection, exposure to azithromycin is associated with a lower frequency of long-term STEC carriage and that among long-term carriers of STEC, azithromycin given for 3 days was associated with decolonization," the researchers wrote. "These findings warrant confirmation for other STEC strains, as well as prospective evaluation and possible clinical trials."

Disclosure: The researchers report no relevant financial disclosures.