A Meta-Analysis on the Effects of Antibiotic Treatment on Duration of Symptoms Caused by Infection with Campylobacter Species

Abstract

Eleven randomized, controlled trials of antibiotic treatment versus placebo in patients with Campylobacter species infection were pooled in a meta-analysis. Antibiotic treatment shortened the duration of intestinal symptoms by 1.32 days (95% confidence interval, 0.64-1.99; P<.0001). Because of problems with drug resistance, a restrictive attitude towards the administration of antibiotics in uncomplicated cases is advised.

Comparison of Disk Diffusion and Agar Dilution Methods for Erythromycin, Ciprofloxacin, and Tetracycline Susceptibility Testing of Campylobacter coli and for Tetracycline Susceptibility Testing of Campylobacter jejuni subsp. jejuni

“…This bacterium may also cause bacteremia (1). Such enteric infections need to be treated with an antimicrobial agent in less than 50% of cases (2,6,15). Macrolides and fluoroquinolones are first-and second-choice antimicrobials for that purpose (2,4,5,6).…”

“…Resistance of C. coli to fluoroquinolones is increasing over time, with the actual resistance rate at 30.8% in the United States (7). Routine susceptibility testing of C. coli has become a very important tool for appropriate antimicrobial treatment when needed (2,(6)(7)(8)(9)(10)(11)(14)(15)(16). The main erythromycin resistance mechanism of C. coli strains (mutation of 23S ribosomal rRNA and proteins) confers high-level resistance (13).…”

“…The main fluoroquinolone resistance mechanism of C. coli strains [mutation(s) of DNA gyrase A] can confer a low, intermediate, or high resistance level to ciprofloxacin and, for most isolates, a high resistance level to nalidixic acid (5,16). Even with resistance rates between 46 and 70%, tetracycline is the third-choice antimicrobial agent for the treatment of C. coli and C. jejuni enteric infections (2,(6)(7)(8)(9)(10)(11)(14)(15)(16), and resistance is mainly mediated by a plasmid (16). In a previous study, using disk diffusion, zone diameters were suggested to be resistant and susceptible breakpoints for erythromycin and ciprofloxacin susceptibility testing of C. jejuni (12).…”

Recrudescent Campylobacter jejuni Infection in an Immunocompetent Adult following Experimental Infection with a Well-Characterized Organism

“…The use of antibiotics for the treatment of Campylobacter infections is generally reserved for patients with moderate or severe disease (dehydrating diarrhea, dysentery), signs of systemic infection (fever, prostration) or underlying immunodeficiency (42). The antimicrobial therapy recommended for C. jejuni infection includes a macrolide antibiotic (i.e., azithromycin or erythromycin) for 3 days, as was initially done for our case subject (20).…”

Infectious diarrhea: when to test and when to treat

“…4 However, in Campylobacter infections, a study published in 1982 showed that antibiotics must be given within four days after symptom onset, 21 and a recent meta-analysis showed that antibiotic treatment shortened the duration of symptoms by only 1.3 days. 22 Although treatment of Salmonella carries with it an in creased risk of chronic carriage, bacteremia can occur in 2%-4% of patients. 4 Therefore, treatment should be considered in individuals with a positive culture result and who are at risk of serious infection or complications of bacteremia (Box 2).…”