As a rule of thumb, I don't treat for 5 days unless they're really ill; at
that point I'll see them and  either send a spec to the lab or Rx erythro
depending on how ill they are. I used to send cultures earlier in everyone,
but here in suburban Surrey there were very very few positives at 3/7. At
5/7 there are more, but, I think, still < 50% unless they're pyrexial

-----Original Message-----
From: GP-UK [mailto:[log in to unmask]] On Behalf Of Paul Caldwell
Sent: 02 January 2007 11:26
To: [log in to unmask]
Subject: Re: Campylobacter - Seasonal diarrhoea - ?antibiotics?

the army found that giving a single dose of antibiotic at the very start of 
infection was v helpful. only problem is that generally diarrhoea, even of 
specific bacterial origin, is usually merely inconvenience with those 
needing active treatment will be sick enough to need admission. generally 
ebm is that ABs are modest effect.
a cautionary tale. when i was on an expedition in n. india, we got struct 
with virulent shigella sonnei diarrhoea, some of whom got it so bad that it 
was first thought they had cholera until pathology came back. this showed it

was resistant to all common ABs and only senstiive to nrofloxacin. the 
micros in srinigar said that resistance was a real concern as a) gut bugs r 
very prone to getting resistance and passi ng it on too to other more lethal

bacteria b) ABs are available otc in india and are used for everthing.
c) community docs rotuinely give ABs in india for diarrhoea.
on balance dont treat methinks.


>From: Martin Goldman <[log in to unmask]>
>Reply-To: GP-UK <[log in to unmask]>
>To: [log in to unmask]
>Subject: Re: Campylobacter - Seasonal diarrhoea - ?antibiotics?
>Date: Tue, 2 Jan 2007 09:24:48 -0000
>
>If you have ever had campylobacter enteritis, you would probably not
>leave it untreated. Can be pretty unpleasant.
>Cipro seems to current wisdom in my area.
>
>Dr Martin Goldman
>Senior Medical Advisor
>Forest Laboratories UK Ltd
>tel +44 (0)1322 550550
>direct line +44 (0)1322 429355
>fax +44 (0)1322 555469
>www.forestlabs.com
>
>-----Original Message-----
>From: GP-UK [mailto:[log in to unmask]] On Behalf Of Marcus Hawkins
>Sent: 01 January 2007 21:49
>To: [log in to unmask]
>Subject: Campylobacter - Seasonal diarrhoea - ?antibiotics?
>
>Here we go with an "old cherry'. To treat or not to treat?
>Tis the season for lots of cooked fowl (& BBQs down here in New
>Zealand).
>Seeing a lot of diarrhoea & sometimes the working diagnosis is
>campylobacter. Some treat with antibiotics automatically & some do not.
>I know that there are guidelines on such matters but I am also
>interested
>in anecdotal experience.
>What do members of the list think about the use of antibiotics in
>campylobacter per se & in the setting of post Xmas/BBQ diarrhoea.
>
>Marcus
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