Volume 1, Number 4—October 1995
Dispatch
An Outbreak of Hemoytic Uremic Syndrome Associated with Antibiotic Treatment of Hospital Inpatients for Dysentery
Table 2
Risk of developing hemolytic uremic syndrome (HUS) by antibiotic combinations used for in-hospital treatment of dysentery during a community outbreak of antibiotic-resistant Shigella dysenteriae type 1, Najran, Saudi Arabia, March through May 1993
| Dysentery patients |
95% | ||||
|---|---|---|---|---|---|
| Antibiotic combination | Developed HUS(10) | Total (42) | HUS rate/100 | Risk ratio a | confidence interval b |
| Ineffective c antibiotics without nalidixic acid d-j | 6 | 12 | 50 | 4.3 | 1.3-15 |
| Ampicillin combinations without nalidixic acid d-f | 5 | 7 | 71 | 6.2 | 1.9-20 |
| Ineffective antibiotics without nalidixic acid or ampicillin g-j | 1 | 5 | 20 | 1.7 | 0.22-14 |
| Ampicillin and nalidixic acid with (2) or without metronidazole (3) | 1 | 3 | 33 | 2.9 | 0.40-20 |
| Trimethoprim-sulfamethoxazole, nalidixic acid and metronidazole | 0 | 1 | 0 | 0 | |
| Nalidixic acid with (24) or without (2) metronidazole (reference) | 3 | 26 | 12 | 1.0 | Reference |
a Relative to the reference antibiotic combination (nalidixic acid with or without metronidazole).
b Taylor series approximation standard.
c Antibiotics to which the outbreak strain of S. dysenteriae type 1 was resistant (ampicillin, trimethoprim-sulfamethoxazole) or which are ineffective against shigella (metronidazole, gentamicin, or erythromycin).
d Ampicillin and metronidazole (4 patients). e Ampicillin, metronidazole, and gentamicin (2 patients).
f Ampicillin only (1 patient). g Trimethoprim-sulfamethoxazole and metronidazole (1 patient).
h Trimethoprim-sulfamethoxazole, erythromycin, and metronidazole (1 patient). i Metronidazole only (2 patients).
j Erythromycin and metronidazole (1 patient).