From the Guidelines
Children can develop chronic Campylobacter infections, although this is relatively uncommon, and treatment usually involves antibiotics such as azithromycin or ciprofloxacin, along with supportive care to manage symptoms and prevent complications. According to the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1, the first choice for treating Campylobacter infections is azithromycin. The guidelines do not specifically address the duration of treatment for chronic infections, but in general, treatment courses for Campylobacter infections can range from 3 to 5 days for acute cases. For chronic cases, the treatment duration may be extended, but this should be determined on a case-by-case basis, considering the severity of the infection, the child's overall health, and their response to treatment.
Some key points to consider in managing chronic Campylobacter infections in children include:
- The importance of maintaining hydration, either through oral rehydration solutions or, in more severe cases, intravenous fluids.
- Monitoring for signs of dehydration, such as decreased urination, dry mouth, or lethargy.
- Being aware that children with underlying conditions, such as inflammatory bowel disease, immunodeficiencies, or malnutrition, are at a higher risk for developing chronic infections and may require more intensive or prolonged treatment.
- Considering the potential for antibiotic resistance, particularly with the use of ciprofloxacin in children under 18, unless the benefits outweigh the risks, as noted in the guidelines 1.
It's also worth noting that while the guidelines provide recommendations for the treatment of various infectious diarrhea causes, including Campylobacter, the management of chronic infections may require a more individualized approach, taking into account the specific circumstances of each case, including the child's health status, the severity of the infection, and any potential complications that may arise.
From the Research
Chronic Campylobacter Infection in Children
- Campylobacter infections are common in children, especially under the age of 15, with the main species responsible being Campylobacter jejuni 2.
- While typically associated with acute gastrointestinal infections, there is evidence to suggest that persistent or recurrent Campylobacter carriage can occur, particularly in hyperendemic settings 3.
- A study found that 45.5% of children experienced at least one persistent Campylobacter episode, with an average cumulative duration of 150 days 3.
- Persistent Campylobacter infections have been linked to negative impacts on linear growth in early childhood, with children experiencing a persistent episode having a lower length-for-age score at 24 months 3.
Risk Factors and Consequences
- Risk factors for persistent Campylobacter infections include environmental contamination and food-borne transmission, particularly through poultry or cross-contamination of raw food 2.
- The infection can lead to systemic infectious complications or postinfectious complications, such as joint or neurological issues, and is more severe in immunosuppressed patients 2.
- Chronic gastrointestinal consequences associated with Campylobacter infection include functional gastrointestinal disorders, inflammatory bowel disease, and celiac disease 4.
Treatment and Management
- Conventional diagnosis by culture is being challenged by molecular and immunoenzymatic methods, which have greater sensitivity 2.
- Antimicrobial treatment, such as azithromycin, can improve digestive symptoms and is effective in decreasing the excretion of Campylobacter species 5.
- Dual antibiotic therapy may be necessary in cases of systemic infection or secondary localization of the infection 2.