The Risk of the Hemolytic–Uremic Syndrome after Antibiotic Treatment ofEscherichia coliO157:H7 Infections
| Autor: | Craig S. Wong, Srdjan Jelacic, Phillip I. Tarr, Rebecca L. Habeeb, Sandra L. Watkins |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Diarrhea
Male Risk medicine.medical_specialty medicine.drug_class Antibiotics Escherichia coli O157 Severity of Illness Index Article Feces Escherichia coli O104:H4 Internal medicine Trimethoprim Sulfamethoxazole Drug Combination medicine Humans Prospective Studies Risk factor Child Prospective cohort study Escherichia coli Infections business.industry Infant Confounding Factors Epidemiologic General Medicine medicine.disease Anti-Bacterial Agents Cephalosporins Logistic Models Hemolytic uremic syndrome (HUS) Child Preschool Relative risk Hemolytic-Uremic Syndrome Immunology Female medicine.symptom business Cohort study |
| Zdroj: | New England Journal of Medicine. 342:1930-1936 |
| ISSN: | 1533-4406 0028-4793 |
| DOI: | 10.1056/nejm200006293422601 |
| Popis: | Children with gastrointestinal infections caused by Escherichia coli O157:H7 are at risk for the hemolytic-uremic syndrome. Whether antibiotics alter this risk is unknown.We conducted a prospective cohort study of 71 children younger than 10 years of age who had diarrhea caused by E. coli O157:H7 to assess whether antibiotic treatment in these children affects the risk of the hemolytic-uremic syndrome and to assess the influence of confounding factors on this outcome. Estimates of relative risks were adjusted for possible confounding effects with the use of logistic-regression analysis.Among the 71 children, 9 (13 percent) received antibiotics and the hemolytic-uremic syndrome developed in 10 (14 percent). Five of these 10 children had received antibiotics. Factors significantly associated with the hemolytic-uremic syndrome were a higher initial white-cell count (relative risk, 1.3; 95 percent confidence interval, 1.1 to 1.5), evaluation with stool culture soon after the onset of illness (relative risk, 0.3; 95 percent confidence interval, 0.2 to 0.8), and treatment with antibiotics (relative risk, 14.3; 95 percent confidence interval, 2.9 to 70.7). The clinical and laboratory characteristics of the 9 children who received antibiotics and the 62 who did not receive antibiotics were similar. In a multivariate analysis that was adjusted for the initial white-cell count and the day of illness on which stool was obtained for culture, antibiotic administration remained a risk factor for the development of the hemolytic uremic syndrome (relative risk, 17.3; 95 percent confidence interval, 2.2 to 137).Antibiotic treatment of children with E. coli O157:H7 infection increases the risk of the hemolytic-uremic syndrome. |
| Databáze: | OpenAIRE |
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