Beta-lactam use associated with worse outcomes for E. coli patients

Smith KE. Pediatr Infect Dis J. 2011;doi:10.1097/INF.0b013e31823096a8.

Beta-lactams, used to treat Escherichia coli O157 infections, may contribute to the subsequent development of hemolytic uremic syndrome, according to researchers at the Minnesota Department of Health.

Kirk E. Smith, DVM, PhD, and colleagues conducted a case-case comparison study that included 66 participants aged younger than 20 years who either had culture-confirmed O157 infection and developed hemolytic uremic syndrome (HUS) or 129 participants who did not develop the condition. The patients were identified through a statewide database compiled between 1996 and 2002.

According to the researchers, being female and vomiting were significantly associated with the development of HUS.

They said after they adjusted for illness severity and gender, the patients who developed HUS were more likely to have been treated only with bactericidal antibiotics within the first 3 days (adjusted matched OR=12.4; 95% CI, 1.4-110.3) or within the first 7 days (OR=18.0; 95% CI, 1.9-170.9) after the onset of diarrhea.

Penicillins or cephalosporin use in the first 3 days put patients more at risk, the researchers said, adding that their findings were in line with other studies suggesting worse outcomes related to antibiotic treatment and E. coli O157 infection.

“We agree with the existing recommendation that antibiotics be avoided for the treatment of O157 infection,” they said.

Disclosure: The researchers report no relevant financial disclosures.

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