Nitschke M. JAMA. 2012;307:1046-1052.
Treatment with azithromycin was associated with a lower
frequency of long-term Shiga toxin-producing enteroaggregative Escherichia
coli, according to researchers from Germany.
For the study, researchers analyzed the duration of
bacterial shedding among those who did and did not receive prophylactic
azithromycin during the May 2011 Shiga toxin-producing E. coli (STEC)
outbreak in Germany.
The cohort included 65 patients with
STEC from one center in Germany. Patients presented from May
15 to July 26 and were monitored for a mean of 39.3 days after onset of
Twenty-two patients received azithromycin and the
remaining 43 did not. Among those who received the antibiotic, long-term STEC
carriage was observed in one patient compared with 35 patients who did not
receive the antibiotic.
All of the 22 patients receiving
azithromycin had at least three STEC-negative stool specimens
after treatment. There was no recurrence of STEC observed among these patients.
Among the 43 patients who did not initially receive azithromycin and who were
long-term STEC carriers, 15 were treated with azithromycin for 3 days and,
subsequently, had negative stool specimens.
"Our findings suggest that among patients with STEC
infection, exposure to azithromycin is associated with a lower frequency of
long-term STEC carriage and that among long-term carriers of STEC, azithromycin
given for 3 days was associated with decolonization," the researchers
wrote. "These findings warrant confirmation for other STEC strains, as
well as prospective evaluation and possible clinical trials."
Disclosure: The researchers report no relevant