title: [Enterocolitis, antimicrobials and hemolytic-uremic syndrome in children: Review of a concept].
abstract: BACKGROUND
  Treatment of children with Escherichia coli O157:H7 enterocolitis could be related with risk of Hemolytic-Uremic Syndrome (HUS). The proscription of antibiotics use until cultures ruled out this infection has been proposed (Wong et al.). This concept became generalized causing dilemma in clinical decisions and research. The objective of this study was to review the evidence related with this topic.
  
  
  METHODS
  A 1999-2011 literature review of studies related with E.coli O157:H7, antibiotics and HUS in children.
  
  
  RESULTS
  We found one randomized controlled trial, three cohort studies, one case-control and one meta-analysis with pediatric data on the topic. After methodological and metrical analysis, five studies showed opposite results as compared to Wong et al. All had statistical power enough to detect Wong's association but did not happen. Wong's study had no statistical power to detect risk ratios ≤ 11.
  
  
  CONCLUSIONS
  These results are neither reproducible nor generalizable, consequently clinical decisions should be solved following local epidemiology.
authors.affiliation: Campus Norte, Departamento de Pediatría, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
authors.forename: Patricio
authors.initials: P
authors.lastname: Herrera
authors.forename: Carlos
authors.initials: C
authors.lastname: Valenzuela
authors.forename: Marcos
authors.initials: M
authors.lastname: Skarmeta
authors.forename: Miguel
authors.initials: M
authors.lastname: Méndez
authors.forename: Alvaro
authors.initials: A
authors.lastname: Bustos-González
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004760:Enterocolitis / Q000188:drug therapy*; D004927:Escherichia coli Infections / Q000188:drug therapy*; D019453:Escherichia coli O157; D006463:Hemolytic-Uremic Syndrome / Q000209:etiology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents