Don't take antibiotics to treat E. coli, medical experts warn

For at least five years, the federal Centers for Disease Control and Prevention, the American Medical Association and other medical groups have advised against using antibiotics in treating E. coli infections because of evidence that they can make patients sicker.

But some doctors still prescribe antibiotics in E. coli cases because they are unaware of the advice, misdiagnose the still-rare E. coli O157:H7 or do not find the relationship between antibiotics and greater medical risk convincing.

The studies exist, "but I don't know how well-known they are," said Dr. David Acheson, chief medical officer in the Food and Drug Administration's food-safety center and one of several experts to warn against antibiotic use in treating the E. coli strain.

A 2000 study found that children infected by E. coli O157:H7 and given antibiotics developed a life-threatening complication called hemolytic uremic syndrome at higher rates than children who did not take antibiotics. The syndrome is the leading cause of kidney failure in children.

It is unclear whether antibiotics have contributed to the severity of the spinach- and Taco Bell-related outbreaks. Ten states are taking part in a study by the CDC to help settle the antibiotic question. Preliminary results are expected by summer 2007.

Scientists who have studied the link aren't awaiting further confirmation.

"It's kind of like aspirin and Reyes syndrome," said Dr. Phillip Tarr, professor of pediatric gastroenterology at Washington University in St. Louis and an author of the 2000 study. "No one ever did a control study that proved aspirin causes Reyes syndrome. But none of us will give aspirin for chickenpox."

Patients suspected of being infected with E. coli should be hospitalized and given intravenous hydration, he said.