Enterovirulent E. coli (EEC)

  • Medical Author:
    Charles Patrick Davis, MD, PhD

    Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

  • Medical Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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How are enterovirulent E. coli infections treated?

Initial treatment methods are similar for all of the EEC groups; hydration is the main treatment, both oral and IV (intervenous) hydration. However, additional treatment measures may be needed. If the patient is infected with EHEC, antibiotics are not used unless the patient is septic. Studies have shown that antibiotics in the EHEC group (especially with E. coli 0157:H7) induce bacteria that produce Shiga toxin to increase toxin release and make the disease and complications worse. In addition, investigators suggest that other toxin producing E. coli serovars in other groups (EPEC, ETEC and EIEC) may not be helped by antibiotics since on some rare occasions; they can develop complications similar to those of EHEC.

Although some cases of traveler's diarrhea have been treated with antibiotics (for example, sulfamethoxazole and trimethoprim [Septra]), in general, antibiotics may reduce symptoms by only about 24/48 hours. EAEC and EAggEC frequently are self-limiting and many of the serovars are resistant to one or more antibiotics. If the decision to use antibiotics in any EEC infection is made, investigators suggest the E. coli serovar causing the infection be tested to determine antibiotic susceptibilities.

How is self-care at home done for enterovirulent E. coli?

The majority of enterovirulent E. coli (EEC) infections are self-limited; they require no treatment except to keep the person well hydrated (oral hydration). This is especially the case for children and the elderly, who may quickly dehydrate during home care. If the person is unable to be stay well hydrated at home, medical care should be sought. Most health care professionals warn people not to treat patients at home with any "left-over" antibiotics or over-the-counter drugs such as diphenoxylate and atropine (Lomotil), because such treatment may make the symptoms worse and cause complications (see complications section).

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