Campylobacter Infections Medication

Updated: Jun 16, 2017
  • Author: Mahmud H Javid, MBBS; Chief Editor: Michael Stuart Bronze, MD  more...
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Medication

Medication Summary

Azithromycin therapy would be a primary antibiotic choice for Campylobacter infections, when indicated (see Medical Care), [20] with a typical regimen of 500 mg/d for 3 days. However, erythromycin is the classic antibiotic of choice. Its resistance remains low, [21] and it can be used in pregnant women and children.

Ciprofloxacin and tetracycline are alternatives but should be avoided in young children. In addition, the use of fluoroquinolones in food animals has resulted in fluoroquinolone-resistant Campylobacter strains worldwide. [22, 23] 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. [24] A 2008 study from the United Kingdom found fluoroquinolone-resistant Campylobacter species in 22% of poultry and 75% of pig farms. [25] High levels of ciprofloxacin resistance have also been reported in developing countries, with resistance ranging from 30% to greater than 70%. [26, 27]

Clindamycin is another therapeutic alternative.

Specific antibiotic doses to treat Campylobacter infections have not been fully defined for tetracycline and clindamycin; therefore, the doses below are empirical.

Antibiotic treatment does not prolong carriage of C jejuni. [28]

CNS infections can be treated with meropenem, [29, 30] ampicillin, [31] or chloramphenicol. [32]

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Antibiotics

Class Summary

Therapy must be comprehensive and cover all likely pathogens in the context of the clinical setting.

Azithromycin (Zithromax)

Acts by binding to 50S ribosomal subunit of susceptible microorganisms and blocks dissociation of peptidyl tRNA from ribosomes, causing RNA-dependent protein synthesis to arrest. Nucleic acid synthesis is not affected.

Concentrates in phagocytes and fibroblasts as demonstrated by in vitro incubation techniques. In vivo studies suggest that concentration in phagocytes may contribute to drug distribution to inflamed tissues.

Treats mild-to-moderate microbial infections.

Plasma concentrations are very low, but tissue concentrations are much higher, giving it value in treating intracellular organisms. Has a long tissue half-life.

Effective against a wide range of organisms, including the most common gram-positive and gram-negative organisms. Has additional coverage of so-called atypical infections such as Chlamydia, Mycoplasma, and Legionella species.

Indicated for treatment of patients with mild-to-moderate infections, including acute bronchitic infections that may be observed with bronchiectasis.

Erythromycin (E-Mycin, Ery-Tab, E.E.S.)

DOC for Campylobacter infections. Macrolide antibiotic that inhibits bacterial growth by blocking dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest. For C jejuni (not C fetus) infections.

Ciprofloxacin (Cipro)

Synthetic, broad-spectrum antibacterial compounds. Novel mechanism of action, targeting bacterial topoisomerases II and IV, leads to a sudden cessation of DNA replication. Oral bioavailability is nearly 100%. For C jejuni (not C fetus) infections.

Clindamycin (Cleocin)

Lincosamide for treatment of serious skin and soft tissue staphylococcal infections. Also effective against aerobic and anaerobic streptococci (except enterococci). Inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes, causing RNA-dependent protein synthesis to arrest.

Doxycycline (Bio-Tab, Doryx, Vibramycin, Doxy, Vibra-Tabs)

Inhibits protein synthesis and thus bacterial growth by binding to 30S and possibly 50S ribosomal subunits of susceptible bacteria. For C jejuni (not C fetus) infections.

Levofloxacin (Levaquin)

For pseudomonal infections and infections due to multidrug resistant gram-negative organisms. For C jejuni (not for C fetus) infections.

Gentamicin (Garamycin, Gentacidin)

Aminoglycoside antibiotic for gram-negative coverage. Used in combination with both an agent against gram-positive organisms and one that covers anaerobes. Not the DOC. Consider if penicillins or other less toxic drugs are contraindicated, when clinically indicated, and in mixed infections caused by susceptible staphylococci and gram-negative organisms. Dosing regimens are numerous; adjust dose based on CrCl and changes in volume of distribution. May be administered IV/IM. For C fetus (not C jejuni) infections.

Imipenem and cilastatin (Primaxin)

For treatment of multiple organism infections in which other agents do not have wide-spectrum coverage or are contraindicated because of potential for toxicity. For C fetus (not C jejuni) infection.

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