Antibiotics for E. coli infections

E. coli can cause infections in the bowel, urinary tract, bloodstream and other sites. The symptoms, infection site, severity and test results determine whether an antibiotic is needed and which one is likely to work.

Many E. coli normally live harmlessly in the bowel. Disease-causing strains behave differently, and resistance can make common antibiotics ineffective. Urine, blood or stool testing may help the clinician choose targeted treatment.

Shiga toxin-producing E. coli can present with severe cramps and bloody diarrhoea. Antibiotics and bowel-slowing anti-diarrhoeal medicines are generally avoided when this infection is suspected because they may increase the chance of haemolytic uraemic syndrome, which can damage the kidneys and blood cells.

Seek clinical advice for bloody diarrhoea, urinary symptoms with fever, or illness that is worsening. Provide a requested sample before starting antibiotics when this is practical, but do not delay emergency care. Drink frequent small amounts of oral rehydration fluid during diarrhoeal illness and avoid preparing food for other people.

Take a prescribed antibiotic exactly as directed. Do not use leftover medicine or assume that a drug used for a previous urinary infection will treat the current one. Report a new rash, facial swelling, breathing difficulty or severe antibiotic-associated diarrhoea promptly.

Get urgent help for very little urine, unusual bruising, marked paleness, extreme tiredness, confusion, fainting, persistent vomiting, severe abdominal or side pain, breathing difficulty, or inability to keep fluids down. After bloody diarrhoea, reduced urine with pallor or bruising may signal haemolytic uraemic syndrome and needs immediate assessment.

Ask which body site is infected, whether culture or toxin testing is pending, why an antibiotic is recommended or being avoided, which symptoms should prompt reassessment, and how to reduce spread at home.