Campylobacter enteritis

Shane, 2017White, 2019

Campylobacter enteritis is a foodborne zoonosis that is usually self-limiting. Rehydration is the mainstay of therapy.

Antibiotic therapy is indicated for patients with severe diarrhoea. Consider therapy for patients who are at increased risk of complications, including infants, patients older than 70 years with frailty, patients in the third trimester of pregnancy, and patients with immune compromise.

The incidence of quinolone-resistant Campylobacter strains is increasingWallace, 2021. If antibiotic therapy is indicated, for infection acquired in Australia, useWallace, 2021:

1azithromycin 500 mg (child: 10 mg/kg up to 500 mg) orally, daily for 3 days azithromycin azithromycin azithromycin

OR

2ciprofloxacin 500 mg (child: 12.5 mg/kg up to 500 mg) orally, 12-hourly for 3 days12. For dosage adjustment in adults with kidney impairment, see ciprofloxacin oral dosage adjustment ciprofloxacin ciprofloxacin ciprofloxacin

OR

2norfloxacin 400 mg (child 6 months or older: 10 mg/kg up to 400 mg) orally, 12-hourly for 3 days34. For dosage adjustment in adults with kidney impairment, see norfloxacin dosage adjustment. norfloxacin norfloxacin norfloxacin

Asymptomatic contacts of the index case do not need faecal testing or treatment.

Patients with undiagnosed HIV infection may present initially with recurrent Campylobacter enteritis. Recurrent Campylobacter enteritis is an indicator condition for HIV testing5. If recurrent Campylobacter enteritis is identified, offer HIV testing, regardless of whether the patient has behavioural or epidemiological risk factors for HIV infection.

1 Ciprofloxacin is not licensed for use in children on the basis of animal studies that showed an adverse effect on cartilage development with quinolone use; however, clinical trial data suggest that adverse musculoskeletal events are usually mild and short term, similar to those observed in adults. Ciprofloxacin can be used in children when it is the drug of choice.Return
2 An oral liquid formulation of ciprofloxacin is not commercially available; for formulation options for children or people with swallowing difficulties, see Don’t Rush to Crush, which is available for purchase from the Advanced Pharmacy Australia website or through a subscription to eMIMSplus.Return
3 Norfloxacin is not licensed for use in children on the basis of animal studies that showed an adverse effect on cartilage development with quinolone use; however, clinical trial data suggest that adverse musculoskeletal events are usually mild and short term, similar to those observed in adults. Norfloxacin can be used in children when it is the drug of choice.Return
4 An oral liquid formulation of norfloxacin is not commercially available; for formulation options for children or people with swallowing difficulties, see Don’t Rush to Crush, which is available for purchase from the Advanced Pharmacy Australia website or through a subscription to eMIMSplus.Return
5 Indicator conditions for HIV testing are conditions that are seen in people with HIV infection (including undiagnosed infection), conditions that share a transmission route with HIV (eg sexually transmissible infections), or conditions for which management is altered in people with HIV infection (eg tuberculosis).Return