1. CONTROL ID: 2378979
CONTACT (NAME ONLY): Neha More
PRESENTATION TYPE: Abstract
CURRENT CATEGORY: Infectious Diseases
Abstract
TITLE: USE OF ANTIBIOTICS IN TREATMENT OF CHILDREN DIAGNOSED WITH ESCHERICHIA COLI 0157:H7
DIARRHEA AND RISK OF DEVELOPING HEMOLYTIC UREMIC SYNDROME (HUS): REVIEW OF THE
LITERATURE
AUTHORS (FIRST NAME INITIAL LAST NAME): N. N. More
1
, N. Cheranda
1
, J. Rozenblit
1
, J. Kim
1
, Y. Kim
1
, N.
Baskaran
1
, M. Vyakaranam
1
, B. Afghani
1, 2
INSTITUTIONS (ALL):
1. University of California, Irvine Medical School, Irvine, CA, United States.
2. CHOC Hospital, Orange, CA, United States.
ABSTRACT BODY:
Purpose of Study: The use of antibiotics in diarrhea caused by Escherichia Coli (E. Coli) 0157:H7 in the pediatric
population remains contentious. The purpose of this review was to determine whether antibiotics increase the risk of
HUS.
Methods Used: PubMed and Google Scholar search engines were used to find studies that included children under
the age of 21 and diagnosed with HUS caused by E. Coli O157:H7.
Summary of Results: Eight studies regarding the use of antibiotics in children with possible signs of HUS satisfied our
inclusion criteria (see tables below for prospective and retrospective studies). Although there were conflicting results,
majority of studies with larger sample size showed giving antibiotics increased the risk of HUS. Severity of disease,
starting antibiotics early during diarrheal phase and bactericidal antibiotics were associated with increased risk of
HUS.
Conclusions: Studies which included larger sample size have shown an increased risk of HUS after use of antibiotics.
Severity of illness, the type of antibiotic and duration of symptoms before start of antibiotics may influence the risk of
developing HUS.
Table 1: Prospective Studies
Author
and Year
Age of
Patients
(yrs)
Total Antibiotic
s used
Those
got
antibiotic
s &
develope
d HUS
Those
without
antibiotic
s &
develope
d HUS
Effect of
Antibiotic
s
(Success
, Harm)
P values
Wong
CS, 2000
<18 71 Variety of
Antibiotic
s
5/9
(56%)
5/62
(8%)
Harm p<0.001
Wong
CS, 2012
<18 259 ampicillin
,
azithrom
ycin,cefot
axime,
and
trimethop
9/25
(36%)
27/234
(12%)
Harm p=0.001

2. rim-
sulfamet
hoxazole
Geerdes-
Fenge
HF, 2013
<18 24 Ciproflox
acin
Cefotaxi
me,
amoxicilli
n,
metronid
azole
4/7
(57%)
15/17
(88%)
No Effect p=0.12
Proulx,
1992
<21 77 Cotrimox
azole
2/22
(9%)
4/25
(16%)
No Effect p=0.67
Table 2: Retrospective Studies
Author
and Year
Age of
Patients
(yrs)
Total Antibiotic
Name
Patients
treated
with
antibiotic
s &
develope
d HUS
Patient
treated
without
antibiotic
s &
develope
d HUS
Effect of
Antibiotic
s
(Success
, Harm
P values
Ostroff,
1989
<10
Subgrou
p
75 Erythrom
ycin,
ampicillin
, and
cotrimox
azole
3/8
(38%)
5/12
(22%)
No to
minor
Effect
p=0.07
Beth P.
Bell,
1997
<15 278 TMP/SM
Z,
Ampicillin
or
Amoxicilli
n,
Cephalos
porin,
Metronid
azole
8/50
(16%)
28/128
(22%)
No Effect p=0.56
Pavia,
1990
<20 23 Cotrimox
azole,
5/8
(72%)
0/7
(28%)
Harm p<0.05

3. sulfonam
ide
Smith
KE, 2012
<20 188 Bacterici
dal
antibiotic
s
12/63
(19%)
6/125
(5%)
Harm p<0.01
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AWARDS: WAFMR/WSPR Outstanding Student Research Awards