From the Guidelines
For patients with Campylobacter infection, antimicrobial therapy is recommended only for those with severe or prolonged disease, or for immunocompromised hosts, with azithromycin or fluoroquinolones being suitable options, as evidenced by a meta-analysis showing a 1 day shorter duration of illness with such treatment 1. When considering treatment for Campylobacter infection, it's crucial to weigh the benefits against the risks, including the potential for antibiotic resistance.
- The majority of cases are self-limited and resolve within a week without specific treatment, requiring only rest and adequate fluid intake to prevent dehydration.
- Severe cases, however, may benefit from antimicrobial therapy, with a meta-analysis confirming an average of 1 day shorter duration of illness with fluoroquinolone or macrolide treatment compared with placebo 1.
- The choice of antimicrobial agent is important, with fluoroquinolone resistance being a concern in many countries, and azithromycin being a suitable alternative.
- Prevention of Campylobacter infection involves proper food handling practices, including thoroughly cooking poultry, avoiding cross-contamination in the kitchen, consuming pasteurized milk products, and practicing good hand hygiene.
- While most people recover completely from Campylobacter infection, complications can include reactive arthritis, Guillain-Barré syndrome, or irritable bowel syndrome in rare cases.
- The increasing use of culture-independent diagnostic tests (CIDT) may facilitate earlier, directed treatment, which could improve outcomes for patients with Campylobacter infection 1.
From the Research
Campylobacter Infections
- Campylobacter infections are typically self-limiting, but antimicrobial treatment may be necessary in severe or prolonged cases 2.
- The most common antimicrobials used to treat Campylobacter infections include macrolides, fluoroquinolones, and tetracyclines 2, 3.
Antimicrobial Resistance
- High levels of resistance to tetracycline and ciprofloxacin have been reported in Campylobacter isolates, while resistance to erythromycin and gentamicin remains relatively low 2.
- The emergence of multidrug resistance in Campylobacter jejuni isolates has been documented, particularly in patients with human immunodeficiency virus 4.
- Extensively drug-resistant (XDR) Campylobacter jejuni infections have been reported, with resistance to multiple antibiotic classes 5.
Treatment Options
- Azithromycin has been shown to be effective in treating Campylobacter enteritis, particularly in areas where ciprofloxacin resistance is prevalent 6.
- Imipenem/cilastatin, a carbapenem antibiotic, has been used successfully to treat patients with XDR Campylobacter jejuni infections 5.
- The use of alternative antibiotics, such as phenicols and glycylcyclines, may be considered in certain cases, but their use is often limited by potential side effects or safety concerns 5.
Diagnosis and Surveillance
- Susceptibility testing is crucial in guiding therapy and monitoring resistance trends in Campylobacter infections 2.
- Molecular determination of Campylobacter resistance via DNA sequencing or PCR-based methods has been performed to identify resistant isolates 2.
- Whole-genome multilocus sequence typing (wgMLST) has been used to determine the genetic relatedness of Campylobacter isolates and identify outbreak strains 5.