What is the role of antibiotics in the treatment of Campylobacter infections?

Updated: Aug 05, 2019
  • Author: Mahmud H Javid, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Answer

The use of antibiotics to treat uncomplicated Campylobacter infections is controversial, with studies showing that erythromycin rapidly eliminated Campylobacter organisms from the stool without affecting the duration of illness. Studies in children with C jejuni dysentery have shown benefit from early treatment with erythromycin. Antibiotics may be indicated if any of the following occur:

  • High fever
  • Bloody diarrhea
  • Excessive bowel movements (ie, >8 stools per day)
  • Worsening symptoms
  • Failure of symptoms to improve
  • Persistence of symptoms for longer than 1 week
  • Pregnancy
  • HIV infection and other immunocompromised states
  • Avoid antimotility agents because they prolong the duration of symptoms and have been associated with fatalities.
  • Individuals with hypogammaglobulinemia who have recurrent C jejuni bacteremia may require fresh frozen plasma with antibiotics.
  • Patients with severe dysentery or a relapsing course may require hospitalization.
  • Patients with endovascular C fetus infections require at least 4 weeks of treatment; gentamicin is believed to be the agent of choice. Treatment with ampicillin or third-generation cephalosporins is an alternative.
  • C fetus CNS infections are rare and should be treated in a prolonged manner with a carbapenem such as meropenem. [15]

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