Antibiotics Are Associated with Elevated Risk for Hemolytic Uremic Syndrome

Investigators have suspected for some time that antibiotics given to children with Escherichia coli O157:H7 infection raise risk for hemolytic uremic syndrome (HUS), but statistical validation has been elusive. A large prospective observational study of almost 10 years' duration now supports the connection.

Investigators enrolled 259 children (age, <10 years) infected with E. coli O157:H7: 25 of them received antibiotics, and 234 did not. Overall, 14% developed HUS. Risk for HUS was higher in those who received antibiotics (36% vs. 12%), as was risk for acute renal failure requiring dialysis (12% vs. 3%); no antibiotic class influenced these risks further. In an analysis that included age, duration of illness, and presenting signs and sympto…