Indications for antibiotic treatment in Campylobacter infection primarily include severe or prolonged illness, immunocompromised status, or systemic infection. Antibiotics are generally not recommended for routine cases of Campylobacter gastroenteritis, as most infections are self-limiting and resolve without specific antimicrobial therapy NICE CG84.
Antibiotic treatment should be considered in patients with severe symptoms such as high fever, bloody diarrhoea, or signs of invasive infection, and in those who are immunosuppressed or have significant comorbidities that increase the risk of complications NICE CG84. Additionally, antibiotic therapy may be warranted in cases where symptoms persist beyond one week or in patients at risk of systemic spread, such as neonates or the elderly NICE CG84.
When antibiotics are indicated, macrolides (e.g., erythromycin or azithromycin) are typically preferred due to their efficacy against Campylobacter species and favourable safety profile Veldhuyzen van Zanten 1994. Fluoroquinolones may be used but resistance is increasingly reported, so local susceptibility patterns should guide therapy Veldhuyzen van Zanten 1994.
In summary, antibiotic treatment for Campylobacter infection is reserved for severe, prolonged, or complicated cases, or for vulnerable patient groups, aligning with UK guidelines on antimicrobial stewardship to avoid unnecessary antibiotic use and resistance development NICE CG84 Veldhuyzen van Zanten 1994.
Key References
- CG84 - Diarrhoea and vomiting caused by gastroenteritis in under 5s: diagnosis and management
- NG63 - Antimicrobial stewardship: changing risk-related behaviours in the general population
- NG147 - Diverticular disease: diagnosis and management
- NG95 - Lyme disease
- (Veldhuyzen van Zanten and Sherman, 1994): Indications for treatment of Helicobacter pylori infection: a systematic overview.