From the Guidelines
Azithromycin is the recommended first-line treatment for Campylobacter infection, particularly in cases of dysentery or severe diarrhea, due to its efficacy and the increasing resistance of Campylobacter to fluoroquinolones. Management of Campylobacter infection primarily involves supportive care, as most cases are self-limiting and resolve within a week 1. Fluid and electrolyte replacement is essential to prevent dehydration from diarrhea. Antibiotics are generally reserved for severe cases, immunocompromised patients, pregnant women, or those with prolonged symptoms. When antibiotics are indicated, azithromycin (500 mg daily for 3 days) is the preferred treatment, as it has been shown to be superior to levofloxacin in achieving clinical cure in settings with high rates of fluoroquinolone-resistant Campylobacter 1.
Some key considerations in the management of Campylobacter infection include:
- The likelihood of treatment efficacy and rapidity of response
- Regional patterns of probable target pathogens and their antimicrobial resistance
- Safety and tolerance profile of the antibiotic
- Simplicity of treatment regimen and patient adherence
- Cost of treatment
The use of fluoroquinolones, such as ciprofloxacin, may be considered in areas with low resistance rates, but their use is generally not recommended due to the increasing resistance of Campylobacter to these antibiotics 1. Erythromycin may be an alternative option, particularly for children and pregnant women. During treatment, patients should maintain good hygiene practices to prevent transmission, including thorough handwashing after using the bathroom and before handling food.
Prevention strategies for Campylobacter infection include:
- Proper food handling
- Thorough cooking of poultry
- Avoiding unpasteurized dairy products
- Avoiding contaminated water
- Avoiding direct contact with infected animals
It is essential to note that the treatment of Campylobacter infection should be guided by the severity of symptoms, the presence of underlying medical conditions, and the likelihood of antibiotic resistance 1.
From the FDA Drug Label
Doxycycline is also indicated for the treatment of infections caused by the following gram-negative microorganisms: ... Campylobacter fetus infections caused by Campylobacter fetus Ciprofloxacin Tablets USP, 250 mg, 500 mg and 750 mg is indicated for the treatment of infections caused by susceptible strains of the designated microorganisms in the conditions and patient populations listed below... Infectious Diarrhea caused by ... Campylobacter jejuni
Management of Campylobacter:
- Ciprofloxacin can be used to treat Campylobacter jejuni infections.
- Doxycycline can be used to treat Campylobacter fetus infections. When choosing an antibiotic, consider the specific species of Campylobacter and the severity of the infection, as well as local epidemiology and susceptibility patterns 2 3.
From the Research
Management of Campylobacter
- Campylobacter is a leading foodborne bacterial pathogen that causes gastroenteritis in humans, and its management is crucial to prevent and control the spread of the disease 4.
- The pathogen has a broad animal reservoir and can infect humans through contaminated food, water, or milk, highlighting the need for a One Health approach to manage the disease 5, 6.
- Antibiotic resistance is a significant concern in the management of Campylobacter, with increasing resistance to fluoroquinolones and macrolides, which are commonly used to treat campylobacteriosis 4, 7, 6.
Treatment Options
- Azithromycin has been shown to be an effective alternative to ciprofloxacin in areas where ciprofloxacin-resistant Campylobacter species are prevalent 7.
- The use of azithromycin has been recommended as a first-line therapy for severe diarrhea, although there is evidence of expanding macrolide resistance 6.
- Innovative intervention regimes, including improvements in hygiene measures and consumer education, are necessary to reduce the burden of campylobacteriosis 5, 6.
Prevention and Control
- Poultry meat products are a major source of human Campylobacter infections, and reducing contamination along the food chain is essential to prevent the spread of the disease 5.
- A One Health approach, involving public health authorities, veterinarians, clinicians, researchers, and politicians, is necessary to reduce the socioeconomic costs associated with Campylobacter infections 5, 6.
- Novel intervention strategies, including the combination of public health and veterinary preventive approaches with consumer education, are needed to combat Campylobacter infections 5, 6.