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For Kids With a Type of E. Coli -- Just Say 'No' to Antibiotics

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WebMD Health News

May 23, 2000 -- Children infected with E. coli O157:H7 -- a bug that can cause severe diarrhea, vomiting, and even death -- should not take antibiotics. According to a new study, the drugs given to fight the infection could actually bring on a potentially fatal complication involving the kidneys.

E. coli can be contracted "from all kinds of things including water, cider, and many different foods," says David Lewis, MD, who reviewed the study for WebMD. The disease can also be spread from person to person, he says. For example, inadequate hand washing after changing the diaper of a sick child can easily result in the bug's rapid spread through a day care center. Lewis is with the Lucile Packard Children's Hospital in Palo Alto, Calif., and Stanford University Medical Center.

According to researcher Craig S. Wong, MD, and colleagues at the University of Washington School of Medicine in Seattle, approximately 15% of those who contract the bug each year will develop hemolytic uremic syndrome, or HUS. It's a serious condition that can result in the need for blood transfusions or even kidney dialysis, in which a machine must do the work of the kidneys. If not fatal, HUS can still cause lingering medical problems.

Wong's team investigated various factors that could potentially increase a child's risk for developing HUS. They studied more than 70 young children sick with laboratory-confirmed E. coli O157:H7 infections. Of the 10 children who developed the complication, five had been given antibiotics.

When a child eats an undercooked hamburger or swallows pool water contaminated with E. coli, it's not really the bacteria that makes them sick. What's responsible for the bloody diarrhea, vomiting, and fever is actually a toxic waste product that the bacteria produce. But, says Lewis, contrary to what you'd expect, and as this study shows, killing the bugs with antibiotics is not the answer. Although it's not yet understood for sure, the antibiotic could cause the bugs to pump out more toxins or to burst open and spill all their toxins at once as they die.

Lewis tells WebMD that the debate over whether to give antibiotics to children with this type of E. coli infection has been raging for quite some time. "This study strongly suggests that it's a very bad idea," he says. "It probably won't help and it might be harmful." If your child suddenly develops bloody diarrhea, he says, "it's important to contact a physician immediately." Until a sample can be taken and tested for the presence of E. coli, "parents should basically sit tight."

Despite the natural impulse to do whatever they can to help their child feel better, Lewis urges parents to avoid a potentially fatal error. The majority of E. coli cases clear up without complication and without antibiotics, he says, and "one thing is for sure: parents should not give leftover antibiotics to a child with bloody diarrhea."

According to the CDC, an estimated 73,000 cases of E. coli infection, resulting in an average 61 deaths, occur in the U.S. each year. Lewis tells WebMD that the long-term focus of research is, and should be, on preventing the disease, starting with the elimination of the bacteria from our food and water supply. "At this point," he says, "we really can't do anything but treat the symptoms." If a child becomes infected, all doctors can do is watch to see if complications arise and then "support the child through it. For now, we really don't have anything definitive once it develops," so the best bet is prevention.

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