Neha abstract submission-2
- 1. CONTROL ID: 2378979 CONTACT (NAME ONLY): Neha More PRESENTATION TYPE: Abstract CURRENT CATEGORY: Infectious Diseases Abstract TITLE: USE OF ANTIBIOTICS IN TREATMENT OF CHILDREN DIAGNOSED WITH ESCHERICHIA COLI 0157:H7 DIARRHEA AND RISK OF DEVELOPING HEMOLYTIC UREMIC SYNDROME (HUS): REVIEW OF THE LITERATURE AUTHORS (FIRST NAME INITIAL LAST NAME): N. N. More 1 , N. Cheranda 1 , J. Rozenblit 1 , J. Kim 1 , Y. Kim 1 , N. Baskaran 1 , M. Vyakaranam 1 , B. Afghani 1, 2 INSTITUTIONS (ALL): 1. University of California, Irvine Medical School, Irvine, CA, United States. 2. CHOC Hospital, Orange, CA, United States. ABSTRACT BODY: Purpose of Study: The use of antibiotics in diarrhea caused by Escherichia Coli (E. Coli) 0157:H7 in the pediatric population remains contentious. The purpose of this review was to determine whether antibiotics increase the risk of HUS. Methods Used: PubMed and Google Scholar search engines were used to find studies that included children under the age of 21 and diagnosed with HUS caused by E. Coli O157:H7. Summary of Results: Eight studies regarding the use of antibiotics in children with possible signs of HUS satisfied our inclusion criteria (see tables below for prospective and retrospective studies). Although there were conflicting results, majority of studies with larger sample size showed giving antibiotics increased the risk of HUS. Severity of disease, starting antibiotics early during diarrheal phase and bactericidal antibiotics were associated with increased risk of HUS. Conclusions: Studies which included larger sample size have shown an increased risk of HUS after use of antibiotics. Severity of illness, the type of antibiotic and duration of symptoms before start of antibiotics may influence the risk of developing HUS. Table 1: Prospective Studies Author and Year Age of Patients (yrs) Total Antibiotic s used Those got antibiotic s & develope d HUS Those without antibiotic s & develope d HUS Effect of Antibiotic s (Success , Harm) P values Wong CS, 2000 <18 71 Variety of Antibiotic s 5/9 (56%) 5/62 (8%) Harm p<0.001 Wong CS, 2012 <18 259 ampicillin , azithrom ycin,cefot axime, and trimethop 9/25 (36%) 27/234 (12%) Harm p=0.001
- 2. rim- sulfamet hoxazole Geerdes- Fenge HF, 2013 <18 24 Ciproflox acin Cefotaxi me, amoxicilli n, metronid azole 4/7 (57%) 15/17 (88%) No Effect p=0.12 Proulx, 1992 <21 77 Cotrimox azole 2/22 (9%) 4/25 (16%) No Effect p=0.67 Table 2: Retrospective Studies Author and Year Age of Patients (yrs) Total Antibiotic Name Patients treated with antibiotic s & develope d HUS Patient treated without antibiotic s & develope d HUS Effect of Antibiotic s (Success , Harm P values Ostroff, 1989 <10 Subgrou p 75 Erythrom ycin, ampicillin , and cotrimox azole 3/8 (38%) 5/12 (22%) No to minor Effect p=0.07 Beth P. Bell, 1997 <15 278 TMP/SM Z, Ampicillin or Amoxicilli n, Cephalos porin, Metronid azole 8/50 (16%) 28/128 (22%) No Effect p=0.56 Pavia, 1990 <20 23 Cotrimox azole, 5/8 (72%) 0/7 (28%) Harm p<0.05
- 3. sulfonam ide Smith KE, 2012 <20 188 Bacterici dal antibiotic s 12/63 (19%) 6/125 (5%) Harm p<0.01 (No Image Selected) AWARDS: WAFMR/WSPR Outstanding Student Research Awards