Document Detail

Effect of early oral fluoroquinolones in hemorrhagic colitis due to Escherichia coli O157:H7.
MedLine Citation:
PMID:  10221035     Owner:  NLM     Status:  MEDLINE    
During the Sakai outbreak of Escherichia coli O157:H7 infection, which was linked to contaminated cafeteria school lunches, there were several treatment modalities with regard to antimicrobial drugs. Patient outcomes among three hospitals with different modalities were compared retrospectively. Hemolytic uremic syndrome did not develop in any of the 15 patients treated with oral fluoroquinolone therapy; however, HUS did develop in three of 15 patients treated with intravenous (i.v.) fosfomycin and in two of 12 patients treated with i.v. cefotaxime and oral fosfomycin. The results indicate that oral fluoroquinolone therapy administered within 3 days of illness is effective in preventing the development of HUS; however, prospective randomized double-blind studies on early antimicrobial therapy of O157 hemorrhagic colitis are necessary. Several antibiotics, including fluoroquinolones, were reported to induce the production or release of Shiga-like toxins (STX) from E. coli O157:H7 in vitro. Although patients were examined for fecal STX, no STX were detected in the stools of patients treated with oral fluoroquinolones. In fact, treatment with fluoroquinolones for 5 days eradicated E. coli O157 in all patients.
M Shiomi; M Togawa; K Fujita; R Murata
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  41     ISSN:  1328-8067     ISO Abbreviation:  Pediatr Int     Publication Date:  1999 Apr 
Date Detail:
Created Date:  1999-05-17     Completed Date:  1999-05-17     Revised Date:  2008-05-21    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  228-32     Citation Subset:  IM    
Department of Pediatrics and Pediatric Emergency Medicine, Osaka City General Hospital, Japan.
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MeSH Terms
Administration, Oral
Anti-Infective Agents / administration & dosage,  therapeutic use*
Bacterial Toxins / analysis
Colitis / drug therapy*,  etiology,  microbiology
Escherichia coli Infections / drug therapy*,  pathology
Escherichia coli O157 / pathogenicity*
Gastrointestinal Hemorrhage / drug therapy*,  etiology,  microbiology
Hemolytic-Uremic Syndrome / drug therapy*,  etiology,  microbiology
Retrospective Studies
Treatment Outcome
Reg. No./Substance:
0/Anti-Infective Agents; 0/Bacterial Toxins; 0/Fluoroquinolones

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