Enterocolitis, antimicrobianos y síndrome hemolítico urémico en niños: Revisión de un concepto

Abstract

Background: Treatment of children with Escherichia coli O157:H7 enterocolitis could be related with risk of Hemolytic-Uremic Syndrome (HUS). The proscription of antibiotics use until cultures ruled out this infection has been proposed (Wong et al.). This concept became generalized causing dilemma in clinical decisions and research. The objective of this study was to review the evidence related with this topic. Methods: A 1999-2011 literature review of studies related with E.coli O157:H7, antibiotics and HUS in children. Results: We found one randomized controlled trial, three cohort studies, one case-control and one meta-analysis with pediatric data on the topic. After methodological and metrical analysis, five studies showed opposite results as compared toWong et al. All had statistical power enough to detect Wong's association but did not happen. Wong's study had no statistical power to detect risk ratios ≤ 11. Conclusion: These results are neither reproducible nor generalizable, consequently clinical decisions should be solved following local epidemiology.