Bacteria deadly with antibiotics

BOSTON - Treating a child with antibiotics can be a deadly choice if the youngster is infected with E. coli bacteria, commonly found on raw hamburger, the New England Journal reports.

The journal felt that the findings by Seattle researchers were so compelling it released the results five weeks before the University of Washington School of Medicine study was set to appear in the June 29 issue.

The study found that children whose diarrhoea was caused by the E. coli O157:H7 strain and who were treated with antibiotics were 17 times more likely to develop a potentially fatal kidney disorder known as haemolytic-uremic syndrome (HUS) than youngsters who were not given antibiotics.

HUS, which is becoming increasingly common, is the leading cause of kidney failure among children, beginning with diarrhoea and vomiting and progressing to low urine output, a swollen abdomen and seizures. The death rate is 40 per cent in adults, but lower in children.

Dr Craig Wong and his colleagues said the risk of administering antibiotics to children who might be suffering from the E. coli infection "exceeds the potential benefit."

The study is available on the Internet at www.nejm.org.

Several large outbreaks of E. coli caused by contaminated hamburger in 1992 and 1993 prompted the federal Government to set new standards for cooking the meat. In about 15 per cent of children who develop an E. coli infection, HUS appears soon after the onset of diarrhoea.

In an effort to resolve conflicting reports that antibiotic treatment might raise the risk of HUS, Dr Wong and his team identified 71 children in Washington, Oregon, Idaho and Wyoming who were infected with E. coli O157:H7 from April 1997 to August 1999.

They found that HUS developed in five of the nine children given antibiotics as compared with five of the 62 children who were not given antibiotics.

The study suggests, they say, that a link between HUS and antibiotic use "is strong and plausible."

They advise against giving antibiotics to children who might be infected with E. coli O157:H7 until stool culture tests show that treatment with antibiotics will not increase the child's risk.

Antibiotic-resistant E. coli bacteria were not responsible for the increased risk of HUS.

- REUTERS

Links:

New England Journal of Medicine