From the Guidelines
Antibiotic of Choice for Campylobacter jejuni Infection
The antibiotic of choice for treating Campylobacter jejuni infections is azithromycin, with a recommended dose of 500mg orally once daily for 3 days 1. This recommendation is based on the high efficacy of azithromycin in achieving clinical cure, especially in areas with high rates of fluoroquinolone-resistant Campylobacter spp. 1.
Alternative Treatment Options
Alternatively, erythromycin may be used at a dose of 250-500mg orally four times daily for 5-7 days. However, the use of ciprofloxacin is not recommended as a first-line treatment due to increasing resistance rates, especially in travelers to certain regions 1. If ciprofloxacin is considered, it should be used at a dose of 500mg orally twice daily for 5-7 days, with careful consideration of resistance rates.
Key Considerations
- Azithromycin is generally well-tolerated with minimal side effects, making it a preferred choice for treating Campylobacter jejuni infections 1.
- The choice of antimicrobial agent may change due to evolving resistance patterns, emphasizing the need for ongoing surveillance and adaptation of treatment guidelines 1.
- In severe cases or for patients with underlying medical conditions, the treatment approach may need to be individualized, taking into account the specific circumstances and the potential risks and benefits of different antibiotic regimens.
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 antibiotic of choice for Campylobacter (C.) jejuni infection is ciprofloxacin (PO) 2.
From the Research
Antibiotic Treatment for Campylobacter jejuni Infection
The choice of antibiotic for treating Campylobacter jejuni infection depends on various factors, including the severity of the infection and the presence of antibiotic resistance.
- Azithromycin is considered an effective treatment option for Campylobacter jejuni infection, particularly in areas where ciprofloxacin resistance is prevalent 3, 4.
- Studies have shown that azithromycin is superior to ciprofloxacin in decreasing the excretion of Campylobacter species and is as effective as ciprofloxacin in shortening the duration of illness 3.
- A randomized, double-blind trial found that single-dose azithromycin was associated with the highest cure rate and the shortest median time to the last unformed stool compared to 3-day azithromycin and levofloxacin regimens 4.
- In cases of extensively drug-resistant Campylobacter jejuni infections, carbapenems such as imipenem/cilastatin may be used as a treatment option 5.
- Whole-genome sequencing data can be used to predict antimicrobial resistance in Campylobacter jejuni isolates, which can inform treatment decisions 6.
Key Findings
- Azithromycin is an effective treatment option for Campylobacter jejuni infection 3, 4.
- Ciprofloxacin resistance is a significant concern in the treatment of Campylobacter jejuni infection 3, 4.
- Carbapenems may be used to treat extensively drug-resistant Campylobacter jejuni infections 5.
- Whole-genome sequencing data can be used to predict antimicrobial resistance in Campylobacter jejuni isolates 6.
Treatment Considerations
- The choice of antibiotic should be based on the severity of the infection and the presence of antibiotic resistance 3, 4, 5.
- Azithromycin is a recommended treatment option for empirical therapy of traveler's diarrhea acquired in areas where ciprofloxacin resistance is prevalent 4.
- Clinicians should maintain a high index of suspicion for extensively drug-resistant Campylobacter jejuni infections and consider the use of carbapenems in such settings 5.