In suspected EHEC infection, what is the recommended management regarding antibiotic therapy?

• A. Do not use antibiotics routinely
• B. Administer broad-spectrum antibiotics immediately
• C. Use antibiotics only after stool culture confirmation
• D. Use antivirals

Answer: (A)

In suspected enterohemorrhagic E. coli (EHEC) infection, avoid using antibiotics routinely. The Shiga-like toxin produced by EHEC can be released in greater amounts when bacteria are killed, which may trigger or worsen hemolytic uremic syndrome (HUS), a serious complication, especially in children. Because of this risk, management focuses on supportive care—adequate hydration, electrolyte and acid-base balance, and careful monitoring for signs of HUS—rather than antibiotic therapy. Antimotility agents should also be avoided. If another infection requiring antibiotics is present, treatment should be considered with caution, but it is not routine for suspected EHEC.