E. Coli Treatments and Medications

What is E. coli?

Escherichia coli, or E. coli, is a bacteria that lives harmlessly in the human gut along with other bacteria. Certain strains of E. coli, however, are invasive, toxic, or both, and can cause a severe infection called E. coli infection. Characterized by watery diarrhea, abdominal cramps, and vomiting, E. coli gut infections are one of the most common causes offood poisoning. The more toxic E. coli strains, however, can be life-threatening.

• Uncooked or partially cooked ground beef
• Unpasteurized or raw milk
• Raw meat
• Fresh, unwashed produce (because of the use of animal feces fertilizer or runoff from cattle farms)
• Contaminated drinking water, particularly well water
• Contaminated food preparation surfaces, such as dirty cutting boards
• Physical contact with farm animals, such as petting zoos
• Person-to-person contact

• Enterotoxigenic E. coli (ETEC) and enteroaggregative E. coli (EAEC) attach themselves to the lining of the intestines and secrete toxins that cause intestinal membranes to lose ions and water, leading to watery diarrhea, but without any fever. ETEC and EAEC infections are commonly called “traveler’s diarrhea” because the infection is usually picked up by traveling to a developing country.
• Enteropathogenic E. coli (EPEC) and diffusely-adherent E. coli (DAEC) also attach themselves to the intestinal lining and secrete toxins that cause the intestinal membranes to secrete water, leading to watery diarrhea without fever. EPEC and DAEC, though, are infections that are more common in young children or infants (infant diarrhea).
• Enteroinvasive E. coli (EIEC) invades intestinal cells and causes watery diarrhea and fever. Enteroinvasive E. coli is a rare form of E. coli that does not produce toxins.
• Enterohemorrhagic E. coli (EHEC) are bacteria that both attach to the intestinal lining and invade intestinal cells. Enterohemorrhagic E. coli include those types of E. coli that produce Shiga toxin (Shigatoxigenic E. coli or STEC) or verotoxin (verotoxigenic E. coli or VTEC). Shiga toxin (Stx) and verotoxin (also called Shiga-like toxin) are serious poisons. These poisons attack and break down the lining of the intestines leading to hemorrhagic colitis, or bloody diarrhea. These poisons can also attack the lining of the glomerulus (an important filtering structure of the kidney) and lead to serious complications such as hemolytic uremic syndrome (HUS), kidney failure, and kidney injury.

Deadly E. coli outbreaks are almost always outbreaks of enterohemorrhagic E. coli, particularly a Shiga toxin-producing strain called E. coli O157:H7.According to the Centers for Disease Control and Prevention (CDC), approximately 73,000 people in the United States are infected each year with Escherichia coli O157:H7. Most people ride out the infection, but about 2,000 people will be hospitalized and about 60 will die each year. The number of people infected annually with less deadly pathogenic E. coli is uncertain.

How is E. coli diagnosed?

E.coli is diagnosed from the symptoms and a stool sample.

• Watery diarrhea
• Stomach cramps
• Nausea
• Vomiting
• Fatigue

• Decreased urination
• Tiredness
• High blood pressure
• Yellow or pale skin
• Unusual bleeding or bruising

E. coli treatment options

E.coli is treated with supportive care. Medications are only rarely used, but hemolytic uremic syndrome due to Shigella poisoning may require hospitalization, intravenous fluid replacement, blood transfusions, or dialysis.

Supportive care

The primary goal of supportive care is to maintain hydration and electrolytes. Drinking fluids and consuming electrolytes are the principal treatments. IV fluids may be required for the most severe cases.

Medications

Medications are only rarely used to treat E. coli gut infections. Antibiotics may increase the number of toxins and the risk of hemolytic uremic syndrome, so they are used in only rare cases. They are never used if there’s any suspicion of an enterohemorrhagic E. coli infection. Antidiarrheal medications are also discouraged. They can slow down movement in the colon and increase the duration of the infection.

Dialysis

Most cases of hemolytic uremic syndrome can be treated with hospitalization and supportive care, such as IV fluids. For severe kidney failure, patients will be put on dialysis to remove waste products from the bloodstream.

Blood transfusions

Red blood cell transfusions or platelet transfusions may be necessary to treat low red blood cell or platelet counts caused by Shiga toxin poisoning in the bloodstream. The most extreme cases of hemolytic uremic syndrome may involve plasma replacement, but its effectiveness is not well-established.

E. coli medications

Most cases of E. coli infections, including enterohemorrhagic E. coli, resolve in a few days without medications. E. coli infections are only very rarely treated with medications. In rare cases, antibiotics may be used, but they are discouraged because they may increase the amount of bacterial toxins in the body. Antidiarrheal medications, because they slow down the colon, also lead to an increase in the concentration of bacterial toxins in the intestines, so they are strongly discouraged.

Antibiotics

Antibiotics are drugs that kill bacteria or prevent them from dividing and growing. E. coli does respond to antibiotics. However, antibiotics may increase the amount of toxins produced by the bacteria, increasing the risk of severe complications such as hemolytic uremic syndrome. For that reason, they are not used in the treatment of E. coli infections. They are never used if Shiga toxin-producing bacteria are present.

What is the best medication for E. coli?

Medications are only rarely used for E. coli infections. Antibiotics and antidiarrheal medications may make the problem worse. There is, then, no “best” medication for E. coli.

The standard dosages above are from the U.S. Food and Drug Administration (FDA) and the National Institute of Health (NIH). Dosage is determined by your doctor based on your medical condition, response to treatment, age, and weight. Other possible side effects exist. This is not a complete list.

What are the common side effects of E. coli medication?

Most cases of E. coli infection are treated with supportive care alone. Medications are rarely used or actively discouraged, so medication side effects are only rarely an issue.

What is the best home remedy for E. coli?

Supportive care is the primary treatment for E. coli, so the most universal treatments are home remedies. The goal of E. coli treatment is to prevent dehydration and loss of electrolytes.

Drink clear fluids

Drink clear fluids throughout the day. To avoid vomiting, don’t drink a lot of fluid all at once, but space out drinking throughout the day. Eventually, you will be able to eat solid foods, but start slowly.

Replace electrolytes

E.coli toxins cause the intestines to dump electrolytes as well as water, so drink broths and soups. When you do start eating, eat electrolyte-rich foods such as bananas.

Practice good hygiene

Remember that as long as the symptoms last, you are shedding E. coli in your feces. Make sure that you don’t use the same bathroom as other family members. If you must, always clean bathroom surfaces with disinfectant after use. Wash your hands regularly throughout the day, especially after using the restroom. Finally, do not prepare food for other people or touch any utensils other people may use for eating.

Rest

Fighting infection wears out the body, so give the body plenty of bed rest. Don’t overdo it, though. Get up, walk, move, or stretch.

What is the best treatment for E. coli?

E.coli infections are treated with supportive care to replace fluids and electrolytes lost because of watery diarrhea.

What antibiotics kill E. coli?

Antibiotics are rarely used to treat E. coli gut infections because they increase the amount of toxins produced by the bacteria. For some infections, such as those caused by Shiga toxin-producing microbes, antibiotics could cause life-threatening complications such as hemolytic uremic syndrome. In rare cases, antibiotics may be used against E. coli infections causing traveler’s diarrhea or infant diarrhea.

What happens if E. coli goes untreated?

In nearly all cases, an untreated E. coli gut infection will resolve in seven to 10 days. In the most severe E. coli infection, called enterohemorrhagic E. coli infection, approximately 15% of patients will develop a severe complication called hemolytic uremic syndrome (HUS) that can result in kidney damage or death. There is no specific treatment to prevent enterohemorrhagic E. coli infection from progressing to HUS.

What should I eat if I have E. coli?

Drink clear fluids for several days. Make sure that some of these fluids are packed with electrolytes, such as broth or soup. Two or three days after the onset of symptoms, diarrhea may ease off. Re-introduce solid foods back into the diet gradually. Bland foods such as rice, toast, and eggs are best. Avoid high-fiber foods, dairy, spicy foods, and fatty foods.

What foods to avoid if you have E. coli?

When you first experience watery diarrhea from an E. coli infection, you should stick to clear liquids such as water, juice, clear soda, and broth. As the diarrhea eases off, you can gradually begin eating bland foods such as rice or dry crackers. Until symptoms have completely abated, avoid spicy foods, fatty foods, high fiber foods, dairy products, apple juice, caffeine, and alcohol.

How do you get rid of E. coli infection?

Most E. coli gut infections will resolve without treatment. In rare cases, an antibiotic may be used to clear up a stubborn infection.

How long does it take to recover from an E. coli infection?

Symptoms such as watery diarrhea and abdominal cramps typically start three days after being exposed to an infectious strain of E. coli. For most E. coli infections, symptoms last for three to five days. Enterohemorrhagic E. coli, however, typically have symptoms that last for seven days or longer.

How is E. coli UTI treated?

E.coli can also infect the urinary tract, but these infections are typically caused by E. coli that normally lives in the gut. E. coli UTIs are treated with antibiotics.

How serious is E. coli in urine?

E.coli in the urine typically indicates a urinary tract infection. Although E. coli lives harmlessly in the gut, it can move to the urinary tract and cause a serious infection.

How long does it take for E. coli to affect you?

When an infectious strain of E. coli is ingested, it typically takes three days for symptoms to appear. Symptoms of E. coli intestinal infection include watery diarrhea (dysentery), abdominal cramps, nausea, vomiting, and sometimes fever. Bloody diarrhea is often an indicator that dangerous strains of E. coli, called enterohemorrhagic E. coli, have invaded the intestinal walls.

Can E. coli go away without antibiotics?

E.coli intestinal infections are rarely treated with antibiotics because they can make the symptoms worse. E. coli intestinal infections almost always resolve on their own without medications.

Does yogurt help with E. coli?

Yogurt does not help treat E. coli gut infections or alleviate symptoms.

Does sugar feed E. coli?

Sugar does not feed infectious E. coli bacteria in the gut. Almost all the sugar that you eat is absorbed by the small intestine, but infectious E. coli live in the large intestine. Sugar may, however, provide food for E. coli that have infected other parts of the body such as the urinary tract, bloodstream, lungs, or central nervous system.

Related resources for E. coli

• E. coli (Escherichia coli)
• Enterohemorrhagic Escherichia Coli (EHEC).
• Hemolytic Uremic Syndrome
• Infection strategies of enteric pathogenic Escherichia