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Volume 1, Number 4—October 1995

Does Treatment of Bloody Diarrhea due to Shigella dysenteriae Type 1 with Ampicilin Precipitate Hemolytic Uremic Syndrome?

Abdulaziz A. A. Bin Saeed, Hassan E. El Bushra, and Nasser A. Al-Hamdan
Author affiliations: Field Epidemiology Training Program, Department of Preventive Medicine, Ministry of Health, Riyadh, Kingdom of Saudi Arabia

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Table 2

Risk of developing hemolytic uremic syndrome (HUS) by antibiotic combination used for treatement of bloody diarrhea (BD), Gizan, Saudi Arabia, 1993

Dysentery patients BD cases admitted to Samtah and Abut-Arish Hospitals
Antibiotic combination group Antibiotic combinations Total (N=110) Developing HUS rate (%) Risk ration 95% Confidence interval
Nalidixic acid with without other antibiotics but no ampicillan (b) N(3/23), N+ G+N+C+A (0/1), M + N = C(0/2), N + C (0/4) 41 3 28 7.3 1 0.23-4.34
No antibiotic No antibiotic (0/12) 12 0 6 0.0 NC(e) P value= 0.629(d)
Antibiotic other than nalidixic acid or ampicillin A(0/1),C(1/0), G(0/1), M+G(0/1) 4 1 4 25.0 1.58 0.22-11.58(e)
Ampicillan with or without other antibiotics but no nalidixic acid 28 10 19 35.7 6.90 0.98-48.68
Ampicillin only P (3/3) 6 3 5 50.0 6.11 1.31-28.54
Ampicillin with other antibiotics but no nalidixic acid P+G(1/2),P+M
0/2), P+M+C
(1/0) P+M+G
(3/8) 22 7 14 31.8 10.50 0.54-205.39
Ampicillin and nalidixic acid with or without other antibiotics P+M+G+N(1/1), P+M+N(0/10),
P+M+N+C(1/0). P+N(1/8),
P+N+A(1/2) 25 4 24 16.0 1.77 0.31-10.21

HUS rate(%) calculated form total number of BD in the five district hospitals using corresponding antibiotic.
a Mantel-Haensel weighted relative risk adjusted to hospital (Epi Info, version 6.02). Analysis restricted for data from Samtah and Abu-Arish hospitals. HUS was not reported for the other three district hospitals.
bReference group. A=amikacin, C=claforan, g=gentamicin, N=nalidixic acid, M=metronidazole, P=ampicillin. Numbers between parentheses in the second colunm (antibiotic combination indicate the (number of patients with HUS who took the corresponding antibiotic combination number or patients with BD who took the same antibiotic combination but did not develop HUS in the five district hospitals).
cNC=not calculated.
dOne-tailed Fisher's exact test.
eAdjusted Mantel-Haenszel relative risk could not be calculated.

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