In cases of patients infected with E. coli strain O157:H7, there is evidence that antibiotics may precipitate development of haemolytic-uraemic syndrome (HUS), a clinical syndrome more common in children but increasingly recognized in adults, without conferring any reasonable benefit.13-16 At least one study in vitro showed that gentamycin may safely reduce the release of shiga toxin (Stx) from Shiga toxin producing E. coli, but evidence is lacking to recommend the use of this antibiotic in most cases.17 If antibiotics must be given, an animal study suggests that macrolides, such as azithromycin, may also be a safer option.18 However, despite the possibility of inclusion of antibiotics in the treatment regimen for E. coli in the future, current evidence favours the avoidance of their use wherever possible.