Hemolytic Uremic Syndrome and Antibiotics!

[FSUSTC]

Why antibiotic worsen hemolytic uremic syndrome ????

[Ryuunosuke]

Avoid unnecessary use of antibiotics or antimotility agents during diarrheal illness. The use of these agents has been shown to increase the incidence of hemolytic uremic syndrome (HUS) because as motility slows, the gut is exposed to the toxins for a longer period of time. Additionally, antibiotic-induced injury to the bacterial membrane favors the acute release of large amounts of toxins. Use of antibiotics has been shown to increase the risk of full-blown HUS by 17-fold, and thus, the recommendation is to avoid its use, except in cases of sepsis.

The biggest article that promoted the thinking against antibiotics is this one from NEJM
http://content.nejm.org/cgi/content/full/342/26/1930