Hi XXXXXXX,

Thanks for writing in.

The information that you have provided suggests that your 4 month old baby is having frequent loose motions and culture has grown significant levels of E. coli bacteria which would respond to only some of the medications. So on all medico legal grounds, there is no escape from therapy. As the bacteria is sensitive to oral drugs like nitrofurantoin, ofloxacin and roxithromycin, there may not be any compulsion at present to start injections. A response to medicines may not be seen for first 3 days with loose motions.

Doctors often prefer to treat serious infections in infants with injections as there is a risk of spread of infection in blood and the seriousness may not be easily made out or monitored in infants.

Infants at this age often get loose stools with feeding which may be completely normal. But if the stools contain lots of mucus or blood, there are chances of a serious bacterial infection as may be in this case. Such infections are usually spread by hands or objects that reach mouth of baby directly or indirectly. So if the baby is top feeding, even feeding articles and feeds itself may cause such infections. Most such infections are spread by contaminated water sources.

We need to practice use of boiled water for family, practice healthy diet, hygiene measures, washing hands before approaching baby and preventing infant from putting non eatables in mouth. Ensure adequate feeding of infants as this may help prevent or reduce risk of dehydration. Do read WWW.WWWW.WW to understand dehydration.

You may go ahead with injections but do confirm with doctor if the three oral medicines mentioned above can be tried prior to it.

Some rare serotypes of E. coli diarrhoea may be not treated with antibiotics due to possibility of a condition called HUS (Hemolytic Uremic Syndrome). Take a print out of this page and discuss it with your treating physician.

I hope this answers your query. Please follow your doctor's advice.

Regards

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