The standard medical recommendation for doctors treating patients infected with any type of Shiga toxin-producing E. coli (STEC) bacteria has been not to use antibiotics out of concerns for an increased risk of life-threatening hemolytic uremic syndrome (HUS).
But a report this month in the Journal of the American Medical Association shows how German doctors had success treating some victims of last year’s giant and deadly outbreak of E. coli O104:H4 with azithromycin. Those who took it cleared the E. coli from their bodies substantially faster than those who did not.
A review of the JAMA piece by Dr. Robert Jasmer, a clinical professor at the University of California, San Franciso, said that by day 35 there were no carriers of the organism in the treated group. But carriage persisted in 57.7 percent of the untreated patients at day 42.
The study was carried out at the University Hospital of Schleswig-Holstein in Lübeck, Germany. Doctors there followed a cohort of 65 patients with confirmed E. coli infection. Twenty two of the patients received azithromycin (along with an antibody known as Soliris) and they had a significantly lower probability of being carriers of the bacteria.
None of the treated patients showed signs of developing HUS and resistance to the antibiotic did not develop.The doctors concluded that three days of treatment with azithromycin cleared the pathogen and that larger studies are warranted to clarify the possible role of antibiotic therapy on other strains of STEC.
Dr. Jasmer noted that the study had some drawbacks in terms of sample size and lack of randomization.
The E. coli outbreak that was centered in Germany last year killed more than 50 people and sickened more than 4,000 throughout many European countries. More than 800 people contracted HUS.
European health authorities eventually traced the outbreak to raw sprouts grown from contaminated seeds — a common source of food poisoning outbreaks all over the world.
