Do you treat Campylobacter (campylobacteriosis) infection in pediatric patients?

From the Guidelines

Campylobacter infections in children should only be treated with antibiotics in cases of severe disease, immunocompromised patients, or those with prolonged symptoms, as the majority of cases are self-limiting and antibiotics may contribute to resistance development. When treatment is necessary, the choice of antimicrobial agent is crucial due to evolving resistance patterns 1. For children with campylobacteriosis, the treatment effect of antimicrobial therapy appears to be largest in patients treated early in the illness course, with a meta-analysis confirming an average of 1 day shorter duration of illness with fluoroquinolone or macrolide treatment compared with placebo 1. Some key points to consider in the treatment of campylobacteriosis in children include:

• The use of antibiotics is generally not recommended for most cases of proven campylobacteriosis, as the benefit of antimicrobial treatment is small and the risks of treatment may outweigh the benefits 1
• Exceptions to this rule include severe infections, immunocompromised hosts, and patients with prolonged or severe disease, where treatment with antibiotics such as azithromycin or erythromycin may be necessary 1
• The increasing use of culture-independent diagnostic tests (CIDT) may facilitate earlier, directed treatment, which can improve outcomes in patients with campylobacteriosis 1
• It is essential to practice good hand hygiene and keep children well-hydrated throughout the illness to prevent the spread of infection to other family members and support the recovery process. In terms of specific treatment regimens, azithromycin is often preferred, with a typical dose of 10 mg/kg (maximum 500 mg) on day one, followed by 5 mg/kg (maximum 250 mg) daily for days 2-5, although alternative options such as erythromycin or ciprofloxacin may be considered in certain cases 1.

From the Research

Treatment of Campylobacter Infection in Children

• Campylobacter infection can be treated with antibiotics, and several studies have investigated the efficacy of different antibiotics in children 2, 3.
• A study published in 2010 found that a single oral dose of azithromycin (30 mg/kg) was effective in eradicating the pathogen and accelerating clinical cure in childhood Campylobacter enterocolitis 2.
• Another study published in 2024 compared the efficacy and tolerability of azithromycin and clarithromycin in pediatric Campylobacter enterocolitis, and found that both antibiotics were well-tolerated and had similar clinical outcomes 3.
• The choice of antibiotic may depend on various factors, including the severity of the infection, the age and weight of the child, and the presence of any underlying medical conditions.

Antibiotic Options

• Azithromycin is a commonly used antibiotic for the treatment of Campylobacter infection in children, and has been shown to be effective in several studies 2, 3.
• Clarithromycin is another antibiotic that has been used to treat Campylobacter infection in children, and has been found to be as effective as azithromycin in some studies 3.
• Other antibiotics, such as erythromycin, may also be used to treat Campylobacter infection in children, although their efficacy may vary depending on the specific circumstances of the infection 2.

Considerations

• The use of antibiotics to treat Campylobacter infection in children should be guided by clinical judgment and based on the severity of the infection and the presence of any underlying medical conditions.
• The development of antibiotic resistance is a concern, and the use of antibiotics should be carefully considered to minimize the risk of resistance 4.
• Further research is needed to determine the most effective antibiotic regimens for the treatment of Campylobacter infection in children, and to develop strategies for preventing the development of antibiotic resistance.