What is the treatment for Campylobacter infection?

From the Guidelines

The treatment for Campylobacter infection should involve azithromycin as the first-line antibiotic, given its efficacy and the increasing resistance to fluoroquinolones like ciprofloxacin, as supported by recent evidence 1.

Key Considerations

• Most cases of Campylobacter infection are self-limiting and resolve within a week with rest, adequate hydration, and electrolyte replacement.
• Antibiotics are recommended for severe cases, patients with high fever, bloody diarrhea, prolonged symptoms, or those who are immunocompromised.
• Azithromycin (500 mg daily for 3 days) is the preferred antibiotic due to its effectiveness against Campylobacter and other bacterial causes of diarrhea, as well as its favorable safety and tolerance profile 1.
• The use of fluoroquinolones like ciprofloxacin is limited by increasing resistance rates, particularly in Campylobacter species, making azithromycin a more reliable choice 1.

Treatment Approach

• Supportive care, including rest, hydration, and electrolyte replacement, should be the initial approach for most patients.
• Antibiotic therapy with azithromycin should be initiated promptly in severe cases or when indicated by the presence of high fever, bloody diarrhea, or prolonged symptoms.
• Patients should avoid anti-diarrheal medications like loperamide in the acute phase, as they may prolong bacterial shedding.
• During recovery, a bland diet can help manage symptoms, with gradual reintroduction of normal foods as tolerated.

Evidence Base

• The recommendation for azithromycin as the first-line antibiotic is based on high-quality evidence from recent studies, including those published in the Journal of Travel Medicine 1 and other reputable sources.
• The increasing resistance to fluoroquinolones, including ciprofloxacin, among Campylobacter species and other enteric pathogens, further supports the use of azithromycin as a preferred treatment option 1.

From the FDA Drug Label

Infectious Diarrhea caused by Escherichia coli (enterotoxigenic strains), Campylobacter jejuni, Shigella boydii†, Shigella dysenteriae, Shigella flexneri or Shigella sonnei† when antibacterial therapy is indicated.

The treatment for Campylobacter infection is ciprofloxacin (PO), as it is indicated for the treatment of infectious diarrhea caused by Campylobacter jejuni 2.

From the Research

Treatment for Campylobacter Infection

The treatment for Campylobacter infection typically involves the use of antibiotics. Some key points to consider include:

• The use of azithromycin has been shown to be effective in treating Campylobacter enteritis, particularly in areas where ciprofloxacin resistance is prevalent 3.
• Azithromycin has been found to be superior to ciprofloxacin in decreasing the excretion of Campylobacter species and is as effective as ciprofloxacin in shortening the duration of illness 3.
• However, increasing resistance to azithromycin has been reported in Campylobacter in recent years, highlighting the need for ongoing monitoring and development of new treatment strategies 4.
• Other antibiotics, such as erythromycin and gentamicin, have also been shown to be effective against Campylobacter, although resistance to these agents has also been reported 5, 6.

Antibiotic Resistance

Antibiotic resistance is a significant concern in the treatment of Campylobacter infections. Some key points to consider include:

• Resistance to ciprofloxacin is common, with 63.2% of isolates showing resistance in one study 5.
• Resistance to erythromycin is less common, but still a concern, with 8.6% of isolates showing resistance in one study 5.
• Azithromycin resistance has also been reported, although it is less common than resistance to ciprofloxacin and erythromycin 4.

Clinical Trials

Clinical trials have been conducted to evaluate the efficacy of azithromycin in treating Campylobacter infections. Some key points to consider include:

• One study found that azithromycin was effective in treating Campylobacter enteritis, with a mean time to clinical cure of 7 days 3.
• Another study found that azithromycin was not significantly more effective than placebo in treating Campylobacter concisus diarrhea in adults, although the study was limited by a small sample size 7.