How are Shiga toxin-producing E. coli (STEC) infections treated?
In most infected individuals, symptoms of a STEC infection last about a week or so and resolve without any long-term problems.
It is generally-accepted medical practice that patients with profuse diarrhea or vomiting should be rehydrated. Evidence from studies of children with STEC O157 infection indicates that early use of intravenous fluids (within the first 4 days of diarrhea onset) may decrease the risk of oligoanuric renal failure.
Treatment of STEC infections with antibiotics has not been shown to improve diarrheal illness. In fact, there is growing evidence that treatment of STEC diarrhea with certain types of antibiotics actually increases the likelihood that patients will go on to develop hemolytic uremic syndrome (HUS). Therefore, experts recommend that antibiotics, as well as anti-motility agents, narcotics, and non-steroidal anti-inflammatory drugs should not be given to patients with acute STEC gastroenteritis. As mentioned above, treatment of E. coli O157:H7 infection with fluids before the onset of HUS can have a protective effect against the development of HUS. Because of this, some experts advise hospital admission and administration of intravenous fluids when a patient is thought to have STEC gastroenteritis.
If HUS develops, there is no specific treatment or cure for the condition. Dialysis may be used to treat the kidney failure, transfusions may be used to treat anemia, and other supportive care is given.