Abstract | BACKGROUND: METHODS: We conducted a prospective cohort study of 71 children younger than 10 years of age who had diarrhea caused by E. coli O157:H7 to assess whether antibiotic treatment in these children affects the risk of the hemolytic-uremic syndrome and to assess the influence of confounding factors on this outcome. Estimates of relative risks were adjusted for possible confounding effects with the use of logistic-regression analysis. RESULTS: Among the 71 children, 9 (13 percent) received antibiotics and the hemolytic-uremic syndrome developed in 10 (14 percent). Five of these 10 children had received antibiotics. Factors significantly associated with the hemolytic-uremic syndrome were a higher initial white-cell count (relative risk, 1.3; 95 percent confidence interval, 1.1 to 1.5), evaluation with stool culture soon after the onset of illness (relative risk, 0.3; 95 percent confidence interval, 0.2 to 0.8), and treatment with antibiotics (relative risk, 14.3; 95 percent confidence interval, 2.9 to 70.7). The clinical and laboratory characteristics of the 9 children who received antibiotics and the 62 who did not receive antibiotics were similar. In a multivariate analysis that was adjusted for the initial white-cell count and the day of illness on which stool was obtained for culture, antibiotic administration remained a risk factor for the development of the hemolytic uremic syndrome (relative risk, 17.3; 95 percent confidence interval, 2.2 to 137). CONCLUSIONS:
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Authors | C S Wong, S Jelacic, R L Habeeb, S L Watkins, P I Tarr |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 342
Issue 26
Pg. 1930-6
(Jun 29 2000)
ISSN: 0028-4793 [Print] United States |
PMID | 10874060
(Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
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Chemical References |
- Anti-Bacterial Agents
- Cephalosporins
- Trimethoprim, Sulfamethoxazole Drug Combination
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Topics |
- Anti-Bacterial Agents
(adverse effects, therapeutic use)
- Cephalosporins
(adverse effects)
- Child
- Child, Preschool
- Diarrhea
(complications, drug therapy, microbiology)
- Escherichia coli Infections
(complications, drug therapy, microbiology)
- Escherichia coli O157
- Feces
(microbiology)
- Female
- Hemolytic-Uremic Syndrome
(etiology)
- Humans
- Infant
- Logistic Models
- Male
- Prospective Studies
- Risk
- Trimethoprim, Sulfamethoxazole Drug Combination
(adverse effects)
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