Potential for using antibiotics combined with a Shiga toxin-absorbing agent for treating 0157:H7 Escherichia coli infections

Antibiotics are not recommended for treating O157:H7 Escherichia coli infections because they may promote Shiga toxin (Stx) release from these bacteria. This could increase the risk of Stx-mediated complications in patients suffering from such infections. Here, we observed increased cell-free Stx in E. coli O157:H7 cultures exposed to sub-inhibitory concentrations of several antibiotics. Synsorb-Pk, an agent with a high affinity for Stx, absorbed Stx activity from the antibiotic-treated cultures. These data suggest certain antibiotics, given in combination with an orally administered Stx-binding agent, may be useful in treating O157:H7 E. coli infections.Key words: Shiga toxin, Synsorb, Escherichia coli, O157:H7, antibiotics, therapy.