[The old and new problems of the antibiotics treatment in hemorrhagic enterocolitis and hemolytic uremic syndrome, according to Japanese epidemiological studies].

The treatment for hemorrhagic enterocolitis due to O157 E. coli infection has been discussed to prevent its aggravation to HUS, especially in terms of the effect of antibiotics. In June, 1996, massive outbreak of the infection occurred in Sakai city, Osaka, Japan. For the purpose of the prevention against secondary infection, antibiotics therapy was employed routinely in Sakai. The epidemiological results were as follows. A total of 25996 school children probably faced infection. Among them 4671 (admission 995) children became symptomatic and 102 developed HUS, leading the ratio of HUS versus symptomatic children to 2.18% which is significantly less than the average occurrence ratio of 4.0% at the same age group nationwide. We studied the possibility of lowering the incidence of HUS by the early diagnosis and the use of antibiotics. According to our survey(86-95), we examined 193 diarrhea associated HUS cases on the effect of antibiotics. There is no meaningful change despite treatment of antibiotics during enterocolitis stage in reducing the complication of HUS, but antibiotics therapy after the onset of HUS brought the prolongation of disease course. These two results were controversial, but the main factor might be the age difference between the two study groups. As previously reported, we could'nt propose the administration of antibiotics to the infants with hemorrhagic enterocolitis due to E. coli O157.