Controversy surrounds the use of antibiotics in the treatment of enterohemorrhagic Escherichia coli (EHEC) infections due to concerns about triggering hemolytic-uremic syndrome (HUS). The most common EHEC serotype causing human diseases worldwide is O157:H7.
Antibiotic therapy is generally NOT beneficial or recommended in patients with EHEC infection (particularly in children <10 years).
WHY? Several studies have shown increased induction of Shiga toxin with antibiotic therapy (i.e fluoroquinolones, trimethoprim-sulfamethoxazole, ampicillin). Shiga toxin is the major virulence factor of EHEC involved in the pathogenesis of HUS.
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