Which antibiotics are used 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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Azithromycin therapy would be a primary antibiotic choice for Campylobacter infections, when indicated (see Medical Care), [30] with a typical regimen of 500 mg/d for 3 days. If the patient is bacteremic, treatment can be extended to two weeks. [31] However, erythromycin is the classic antibiotic of choice. Its resistance remains low, [32] and it can be used in pregnant women and children.

The use of fluoroquinolones in food animals has resulted in fluoroquinolone-resistant Campylobacter strains worldwide. [33, 34] Quinolone resistance of C jejuni and Campylobacter coli is conferred by the mutation gyrA C-257-T, which can be identified with methods such as multiplex PCR. [35] A 2008 study from the United Kingdom found fluoroquinolone-resistant Campylobacter species in 22% of poultry and 75% of pig farms. [36] High levels of ciprofloxacin resistance have also been reported in developing countries, with resistance ranging from 30% to greater than 70%. [37, 38] Some evidence has shown that multidrug resistance in pediatric patients in developing countries may be related to the food chain. [39] Consequently, their use as empiric therapy should be avoided.

Infections involving macrolide resistance could be treated with amoxicillin-clavulanate. [40]

Specific antibiotic doses to treat Campylobacter infections have not been fully defined for tetracycline, therefore, the noted doses are empirical. Tetracyclines should be avoided in pregnancy and children.

Antibiotic treatment does not prolong carriage of C jejuni. [41]

CNS infections can be treated with meropenem. [42, 43] Life-threatening infections can be treated with carbapenems and aminoglycosides.

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