In a case of suspected Campylobacter gastroenteritis, what is the best way to confirm the diagnosis? What provides the most effective treatment?
—Clark G. Tristshauser, MD, Medina, N.Y.
Stool culture is the best way to diagnose infection with Campylobacter, which is the most common bacterial cause of infectious colitis. In most patients, symptoms resolve without need for antibiotic therapy. Antibiotics should be given for those who are severely ill, elderly, pregnant, or immunosuppressed. Erythromycin is the drug of choice (500 mg twice daily for five days); macrolides can be used for resistant strains. For strains resistant to erythromycin or fluoroquinolone, try azithromycin or clarithromycin. In the event of severe systemic infections, an aminoglycoside or carbapenem can be used.
—Christina M. Surawicz, MD (111-13)