From the Guidelines
Azithromycin is the recommended first-line treatment for campylobacter infections, particularly for severe cases or those with high fever, bloody diarrhea, or compromised immune systems, due to its efficacy and safety profile compared to other antibiotics like ciprofloxacin 1.
Key Considerations
- The choice of antibiotic should be based on the severity of the illness, the likelihood of treatment efficacy, and regional patterns of antimicrobial resistance.
- Azithromycin has been shown to be superior to levofloxacin in achieving clinical cure in settings with high rates of fluoroquinolone-resistant Campylobacter spp. 1.
- Ciprofloxacin may still be considered as an alternative, but its use is limited by the increasing resistance rates of Campylobacter spp. to fluoroquinolones 1.
Treatment Recommendations
- Azithromycin: 500mg daily for 3 days or a single 1-gm dose 1.
- Ciprofloxacin: 500mg twice daily for 5-7 days, although its use is not recommended as a first-line treatment due to resistance concerns 1.
Prevention and Control
- Proper food handling practices, such as cooking poultry thoroughly to 165°F (74°C), avoiding cross-contamination, and washing hands thoroughly after handling raw meat, can help prevent campylobacter infections.
- Consuming only pasteurized dairy products and avoiding unpasteurized milk can also reduce the risk of infection.
From the Research
Campylobacter Overview
- Campylobacter species are a major cause of food-borne bacterial infectious gastroenteritis worldwide 2
- The most common species of Campylobacter associated with human illness is Campylobacter jejuni, but other Campylobacter species can also cause human infections 3
- Symptoms of intestinal campylobacteriosis include abdominal pain, diarrhea, and fever 2
Treatment and Antibiotic Resistance
- Azithromycin is effective in treating Campylobacter enteritis, especially in areas where ciprofloxacin resistance is prevalent 4
- A single oral dose of azithromycin (30 mg/kg) is superior to a 5-day erythromycin regimen or no antibiotic in treating Campylobacter enterocolitis in children 5
- However, high levels of resistance to azithromycin (69.7%) have been reported in human Campylobacter isolates in South Africa 6
- Resistance to other antibiotics, such as erythromycin, clindamycin, and ciprofloxacin, is also common among Campylobacter species 6
Epidemiology and Prevention
- Poultry meat products are a major source of human Campylobacter infections 2
- A "One World-One Health" approach is required to reduce the burden of campylobacteriosis, including improvements in hygiene measures, agricultural remediation, and consumer education 2
- Innovative intervention strategies, such as novel murine infection models, are being developed to combat Campylobacter infections 2