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Treating Intestinal E. coli Infection With Antibiotic May Reduce Duration of Bacterial Carriage

In the E coli outbreak in Germany in May 2011, treatment with azithromycin was associated with a lower frequency of long-term carriage of the bacteria and shorter duration of shedding of the bacteria in stool specimens, according to a study in the March 14 issue of JAMA.

"Since May 2011, a large outbreak of Shiga toxin-producing Escherichia coli (STEC) has caused 3,816 documented infections in Germany, including 845 confirmed cases of hemolytic uremic syndrome [HUS; a condition characterized by the breakup of red blood cells and kidney failure]," the authors write. "According to existing recommendations, antibiotic treatment of STEC infection is discouraged because this therapy might increase the risk of HUS development." The researchers add that long-term carriage can cause persistent diarrheal symptoms. "Moreover, long-term carriers of enteropathogenic [capable of causing disease in the intestinal tract] bacteria represent a chronic risk of human-to-human transmission and, therefore, their individual social and working life is legally restricted by the German health authorities, posing a high psychological and socioeconomic burden."

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