Medicines for E. coli infection

What it is

Escherichia coli (E. coli) is a type of bacteria, many strains of which live harmlessly in the bowel of humans and animals. However, some strains can cause illness. There are two main ways E. coli causes problems. First, certain strains cause food poisoning (gastroenteritis) — caught from contaminated food (such as undercooked meat, especially minced beef, unpasteurised milk, and contaminated vegetables or water) or contact with infected animals or people — causing diarrhoea (sometimes bloody), stomach cramps, and vomiting. Some of these strains (such as certain "Shiga toxin-producing" E. coli, including E. coli O157) can cause more severe, bloody diarrhoea and, importantly, occasionally lead to a serious complication affecting the kidneys and blood (haemolytic uraemic syndrome), particularly in young children and older people. Second, E. coli is also the most common cause of urinary tract infections, and can cause other infections elsewhere in the body. So "E. coli infection" covers a range, from common urine infections and usually self-limiting food poisoning to, less commonly, more severe illness. The approach depends on the type and site of infection.

How it is treated

Management depends on the type of E. coli infection. For E. coli food poisoning (gastroenteritis), the mainstay is supportive care — staying well hydrated to replace fluids lost through diarrhoea and vomiting (with oral rehydration solutions if needed), resting, and eating when able; most cases settle on their own. Importantly, for the strains that can cause severe illness (such as E. coli O157), antibiotics and anti-diarrhoeal medicines are generally avoided, as they may increase the risk of the serious kidney complication — so these infections are managed supportively with careful monitoring, especially in young children and older people, who need watching for signs of the kidney complication and prompt hospital care if it develops. Preventing spread and further cases is important, through thorough handwashing, food hygiene, and staying off work or school until 48 hours after symptoms settle. For E. coli urinary tract infections, treatment is with appropriate antibiotics, as for other UTIs. Other E. coli infections are treated according to their site and severity. Prevention centres on food hygiene (thorough cooking, avoiding cross-contamination, washing produce), hand hygiene, and care around animals and farms. The reassuring message is that most E. coli food poisoning settles with good hydration, that severe strains are managed carefully with monitoring (avoiding certain treatments), and that E. coli urine and other infections are treated with appropriate antibiotics.