From the Guidelines
Campylobacter infection found in stool is typically treated with antibiotics, primarily macrolides, with azithromycin being the first-line treatment due to its effectiveness and lower resistance issues compared to fluoroquinolones. The recommended dosage for azithromycin is 500 mg once daily for 3 days, as supported by the guidelines for the prevention and treatment of travelers' diarrhea 1. This recommendation is based on the high level of evidence that azithromycin is superior to levofloxacin in achieving clinical cure, especially in settings with high rates of fluoroquinolone-resistant Campylobacter spp. 1.
Some key considerations for the treatment of Campylobacter infection include:
- The decision to treat should be based on the severity of illness and the impact on the patient's activities and plans.
- Antibiotics have been shown to reduce symptom duration in travelers' diarrhea, including those caused by Campylobacter, from an average of 50-93 hours to 16-30 hours 1.
- Azithromycin is generally well-tolerated with minimal side effects, making it a preferred choice for treatment.
- Supportive care, including maintaining hydration and using anti-diarrheal medications cautiously, is essential regardless of antibiotic use.
It's also important to note that while ciprofloxacin can be used as an alternative, resistance is increasing globally, and its use should be considered based on regional patterns of probable target pathogens and their antimicrobial resistance 1. The choice of antimicrobial agent may change due to evolving resistance patterns, as highlighted in the 2017 Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea 1.
In terms of specific treatment recommendations, the guidelines suggest that azithromycin is the first choice for treating Campylobacter infections, with ciprofloxacin as an alternative 1. The treatment duration may be extended to 7-14 days for severe cases or immunocompromised patients. Overall, the goal of treatment is to reduce symptom duration, prevent complications, and improve quality of life, while also considering the potential risks and benefits of antibiotic use.
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 group found in stool is ciprofloxacin (PO), as it is indicated for the treatment of infectious diarrhea caused by Campylobacter jejuni 2.
From the Research
Treatment of Campylobacter Infections
- The treatment of Campylobacter infections typically involves the use of antibiotics, with azithromycin and ciprofloxacin being commonly used options 3.
- However, resistance to these antibiotics is a growing concern, with studies showing high levels of resistance to ciprofloxacin and azithromycin in Campylobacter isolates 4, 5, 6.
- Amoxicillin/clavulanic acid has been proposed as a potential treatment option for campylobacteriosis, given its high susceptibility rates 5.
Antibiotic Resistance Patterns
- The resistance patterns of Campylobacter species vary by region and country, with studies showing different levels of resistance to various antibiotics 4, 5, 6.
- In general, Campylobacter species have been shown to be resistant to a range of antibiotics, including macrolides, fluoroquinolones, and tetracyclines 4, 5, 6.
- The use of antibiotic resistance profiles can help guide treatment decisions and inform public health policy 7.
Treatment Outcomes
- Studies have shown that azithromycin is effective in treating Campylobacter infections, particularly in areas where ciprofloxacin resistance is prevalent 3.
- However, the emergence of azithromycin-resistant Campylobacter strains is a concern, and alternative treatment options may be needed 4, 5.
- Further research is needed to evaluate the effectiveness of different treatment options and to inform public health policy 7.