Does levofloxacin induce hemolytic uremic syndrome in patients infected with verotoxin-producing Escherichia coli O157 infections?

Fifteen Japanese colitis patients, aged above 16 years old, infected with verotoxin-producing Escherichia coli O157 (VTEC O157) were divided into 2 treatment groups. Of the 15 patients, 6 (mean ± SD, 41.3 ± 19.0 years old) were treated with levofloxacin (LVFX), while the remaining 9 patients (32.0 ± 10.0 years old) were not treated with any antimicrobial agents. All patients complained of abdominal pain and bloody stool and were not administered antidiarrheals. Hemolytic uremic syndrome (HUS) did not develop in any of the 6 patients treated with LVFX, but developed in 1 of the 9 patients not treated with antimicrobial agents. No statistical difference was found in the occurrence rate of HUS between LVFX-treated patients and patients not treated with antimicrobial agents. Our results suggest that oral administration of LVFX is not associated with risk of HUS in hemorrhagic colitis patients aged above 16 years infected with VTEC O157.