## Drug of Choice for Campylobacter Infection **Key Point:** Azithromycin (a macrolide) is the first-line antibiotic for Campylobacter jejuni gastroenteritis, particularly in cases with systemic symptoms or severe disease. ### Rationale for Azithromycin 1. **Mechanism:** Azithromycin is a 15-membered macrolide that inhibits bacterial protein synthesis and has excellent activity against Campylobacter species. 2. **Clinical efficacy:** Reduces duration of diarrhea and bacterial shedding when started early in infection. 3. **Penetration:** Achieves good intracellular and mucosal concentrations. 4. **Resistance patterns:** Campylobacter shows emerging fluoroquinolone resistance (up to 40% in some regions), making macrolides more reliable. ### Alternative Agents | Agent | Role | Limitation | |-------|------|------------| | Ciprofloxacin | Second-line (if susceptible) | Rising resistance; not preferred empirically | | Ceftriaxone | Severe systemic infection / bacteremia | Overkill for uncomplicated gastroenteritis | | Metronidazole | Anaerobic coverage only | No activity against Campylobacter | **High-Yield:** In India, where fluoroquinolone-resistant Campylobacter is increasingly common, azithromycin remains the most reliable empiric choice for community-acquired Campylobacter diarrhea. **Clinical Pearl:** Early antibiotic therapy (within 3 days of symptom onset) is most effective; delayed treatment offers minimal benefit. **Mnemonic:** **MAC-C** — **M**acrolides (Azithromycin) for **C**ampylobacter.
Sign up free to access AI-powered MCQ practice with detailed explanations and adaptive learning.