Antibiotics May Harm Children with Diarrhea
June 5, 2000
Increases Risk of Kidney Disease
Antibiotics may actually make children sicker when given for diarrhea, according to a new study. Children who got antibiotics for diarrhea caused by E. coli 0157:H7 had a 17 percent greater chance of getting hemolytic uremic syndrome, a severe, life-threatening kidney and blood disease, report Dr. Phillip Tarr and colleagues from Children's Hospital and Regional Medical Center and the University of Washington School of Medicine in Seattle.
The research appears in the June 29 issue of the New England Journal of Medicine at www.nejm.org/content/2000/0342/0026/TOC.asp. The journal released the findings early--on May 23--because of potential clinical implications.
"This study is both a reminder to be cautious about using antibiotics and a warning about using them in children with diarrhea," commented Dr. Josephine P. Briggs, a kidney specialist and director of kidney research at the National Institute of Diabetes and Digestive and Kidney Diseases.
Toxins from the E. coli 0157:H7 bacteria cause diarrhea (sometimes bloody), vomiting, abdominal pain, and damage to red blood cells, platelets, blood vessels, and the kidneys. Neurological and other problems may also occur. Victims are usually children between 1 and 10 years old. Five to 10 percent die during the initial stage of the disease, and between 10 and 40 percent of survivors will have permanent kidney damage.
Tarr's team studied 71 children who had E. coli 0157:H7 infections in Washington, Oregon, Idaho, and Wyoming. Ten (14 percent) developed HUS, four needed dialysis, and seven had to be given platelets, red blood cells, or both. Of the children who received antibiotics, 56 percent (5 of 9) got HUS, compared to only 8 percent (5 of 62) of those who did not get antibiotics.
"These findings are important and consistent with earlier observations that antibiotics can cause the bacteria to release more of the toxins that cause the damage to platelets, blood vessels and the kidneys," explained Briggs.
Dr. Tarr's work is funded in part by the Pediatric Nephrology Program of the National Institute of Diabetes and Digestive and Kidney Diseases, part of the National Institutes of Health. Dr. Tarr is a pediatric gastroenterologist. His coauthors are C.S. Wong, S. Jelacic, R.L. Habeeb, and S.L. Watkins.
A fact sheet on HUS is at www.niddk.nih.gov/health/kidney/summary/hus/index.htm and one on diarrhea is at www.niddk.nih.gov/health/digest/pubs/diarrhea/diarrhea.htm on the Internet.
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Page last updated: April 17, 2008
