SynthesisClinical infectious diseases : an official publication of the Infectious Diseases Society of America2016
Shiga Toxin-Producing Escherichia coli Infection, Antibiotics, and Risk of Developing Hemolytic Uremic Syndrome: A Meta-analysis.
Synthesis in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 119 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
119 citing papers in PubMed, 4 syntheses or guidelines pooled it, 257 citations in OpenAlex.
- Interventions for preventing diarrhoea-associated haemolytic uraemic syndrome.The Cochrane database of systematic reviews · 2025Pooled it
- Eculizumab in Shiga toxin-producing Escherichia coli hemolytic uremic syndrome: a systematic review.Pediatric nephrology (Berlin, Germany) · 2024Pooled it
- Interventions for preventing diarrhoea-associated haemolytic uraemic syndrome.The Cochrane database of systematic reviews · 2021Pooled it
- 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Guideline
- Serology as an early diagnostic tool in pediatric patients with Shiga toxin-producingJournal of clinical microbiology · 2026Trial
- High-throughput transposon sequencing identifies HprR as a key regulator of the LEE operon and virulence inVirulence · 2026Article
- Bacterial serine protease EspP induces differentiation and expansion of enteroendocrine cells in human colonoids.Physiological genomics · 2026Article
- Protective effects of bismuth hydroxide against hemolytic uremic syndrome caused by Shiga toxin producing Escherichia coli.Folia microbiologica · 2026Article
- Analysis of causes and outcomes of principal secondary thrombotic microangiopathy: a 9-year cohort study from a tertiary pediatric center in China.Research and practice in thrombosis and haemostasis · 2026Article
- Shiga toxin-centered pathophysiology defines the therapeutic limits of enterohemorrhagic Escherichia coli infection.Archives of microbiology · 2026Review
- Improving hemolytic uremic syndrome diagnosis in children: the role of serology for Shiga toxin-producing Escherichia coli detection.Pediatric nephrology (Berlin, Germany) · 2026Article
- Inter-society consensus on the management of acute bloody diarrhea and shiga toxin-producing Escherichia coli infection in the molecular microbiology era.Italian journal of pediatrics · 2026Review
- Antimicrobial Resistance Gene Profiles in Integron-Positive and Integron-Negative Third-Generation Cephalosporin-ResistantAntibiotics (Basel, Switzerland) · 2026Article
- Integrated genomic and phenotypic characterization of antimicrobial resistance in Shiga toxin-producing Escherichia coli from asymptomatic carriers in Japan.Scientific reports · 2026Article
- Bloody diarrhea, STEC infection, and HUS in the molecular microbiology era.Pediatric nephrology (Berlin, Germany) · 2026Review
- Shiga Toxin-Producing Escherichia coli Outbreak in Canadian Daycare Centers.JAMA network open · 2026Article
- Development of an impedimetric aptasensor for Shiga-like toxin 1 using a DNA aptamer and an interdigitated microelectrode.RSC advances · 2026Article
- Genomic epidemiology reveals statewide dispersal of clinical Shiga toxin-producingMicrobiology spectrum · 2026Article
- Pathogenesis and therapeutic strategies in the interaction between gut microbiota and enterohemorrhagic Escherichia coli infection.FEMS microbiology reviews · 2026Review
- Explainable AI-SERS approach for highly accurate discrimination ofCurrent research in microbial sciences · 2026Article
59 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
28 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundAntibiotic administration to individuals with Shiga toxin-producing Escherichia coli (STEC) infection remains controversial. We assessed if antibiotic administration to individuals with STEC infection is associated with development of hemolytic uremic syndrome (HUS).
methodsThe analysis included studies published up to 29 April 2015, that provided data from patients (1) with STEC infection, (2) who received antibiotics, (3) who developed HUS, and (4) for whom data reported timing of antibiotic administration in relation to HUS. Risk of bias was assessed; strength of evidence was adjudicated. HUS was the primary outcome. Secondary outcomes restricted the analysis to low-risk-of-bias studies employing commonly used HUS criteria. Pooled estimates of the odds ratio (OR) were obtained using random-effects models.
resultsSeventeen reports and 1896 patients met eligibility; 8 (47%) studies were retrospective, 5 (29%) were prospective cohort, 3 (18%) were case-control, and 1 was a trial. The pooled OR, including all studies, associating antibiotic administration and development of HUS was 1.33 (95% confidence interval [CI], .89-1.99; I(2) = 42%). The repeat analysis including only studies with a low risk of bias and those employing an appropriate definition of HUS yielded an OR of 2.24 (95% CI, 1.45-3.46; I(2) = 0%).
conclusionsOverall, use of antibiotics was not associated with an increased risk of developing HUS; however, after excluding studies at high risk of bias and those that did not employ an acceptable definition of HUS, there was a significant association. Consequently, the use of antibiotics in individuals with STEC infections is not recommended.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.