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Antibiotic therapy for infection with Shiga toxin-producing Escherichia coli (STEC) is not generally recommended, because it is thought to increase levels of released Shiga toxin (Stx), leading to the severe complication of haemolytic uraemic syndrome (HUS) (Tarr et al., 2005). However, the incidence of HUS in children with STEC infection was found not to be higher in Japan than in other countries, despite the use of antibiotics such as fosfomycin (FOM) (Ikeda et al., 1999; IDSC, 2007). Furthermore, early administration of FOM, as well as a new quinolone, norfloxacin (NFLX), and kanamycin, was recommended in the 1997 guidelines for medical treatment of STEC O157 infection issued by the Ministry of Health and Welfare of Japan. Hence, it remains controversial whether the use of antibiotics for STEC infection is effective or harmful (Wong et al., 2000; Bennish et al., 2006; Panos et al., 2006).

journal of medical microbiology/journal of medical microbiology

Effects of fosfomycin on Shiga toxin-producing Escherichia coli: quantification of copy numbers of Shiga toxin-encoding genes and their expression levels using real-time PCR