Treatment of enterohaemorrhagic E.coli

Seek expert advice.

If a child is suspected of having an E. coli 0157 infection then urgent assessment by a paediatrician is indicated - hospital admission should be considered if features suggestive of E. coli O157 (eg, acute bloody diarrhoea and severe abdominal pain; children aged less than 5 years are at greatest risk of developing HUS, usually 1 week after onset of bloody diarrhoea).

Treatment is supportive.

Non-specific supportive therapy, including hydration, is important.

Antimotility drugs are contraindicated because of the increased risk of development of haemolytic uraemic syndrome (HUS)

• avoid antidiarrhoeal drugs and opioid analgesics
  • there is an increased risk of developing HUS or other complications of E.coli infection associated with use of antimotility agents and opioid analgesics

During the week after the onset of the diarrhoea, the patient should be monitored for features of HUS (oliguria, oedema and weight gain, pallor; monitor blood count, platelets, renal function and electrolytes).

Antibiotics should not be used to treat this infection.

Reference:

• 1) CMO's Update 27 (August 2000), 6.
• 2) Pennington, T. H. (2014). E. coli O157 outbreaks in the United Kingdom: past, present, and future. Infection and Drug Resistance, 7, 21-222.