Advice to Clinicians

Published on December 17, 2019 at 5:00 PM ET

Campylobacter bacteria isolated from clinical samples from ill people in this outbreak were resistant to recommended, first-line antibiotics used to treat severe Campylobacter infections.

  • WGS analysis of 26 isolates from stool from ill people found that 22 (85%) were resistant to multiple antibiotics: azithromycin, ciprofloxacin, clindamycin, erythromycin, nalidixic acid, telithromycin, and tetracycline.

Clinicians should consider the following when managing patients who have suspected or confirmed Campylobacter infection related to this outbreak:

  • Supportive care (for example, rehydration, and electrolyte repletion) should be sufficient for most patients.
  • For patients who may require antibiotics (for example, those who are at high risk for serious illness, such as infants and young children, adults aged 65 years and older, pregnant women, and people with compromised immunity):
    • Order stool culture and antimicrobial susceptibility testing.
    • Choose an antibiotic based on the results of the patient’s stool cultures and antimicrobial susceptibility testing.
    • Consider consulting an infectious disease specialist for patient management.
  • When empiric treatment is required, avoid agents to which the outbreak strain is resistant. This includes the antibiotics listed above as well as penicillins, amoxicillin-clavulanic acid, cephalosporins, metronidazole, and trimethoprim-sulfamethoxazole, to which Campylobacter jejuni are inherently resistant.
    • Carbapenem antibiotics (such as meropenem or imipenem) may be an alternative for infections that are resistant to recommended treatment agents.