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Antimicrobial use associated with risk for campylobacteriosis
Koningstein M. Clin Infect Dis. 2011:53:644-650.
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Fluoroquinolones increased the risk for acquiring campylobacteriosis, but macrolides served as a protective factor for infection, according to Kåre Mølbak, MD, DMSc, and colleagues.
“Treatment with macrolides may protect against Campylobacter infection for a limited period of time, possibly due to the antibacterial effects of the drug or its metabolites,” Mølbak and colleagues wrote in the study. “Fluoroquinolone treatment confers increased risk, probably due to a combination of competitive and selective effects, similar to what has been observed for nontyphoid Salmonella infection.”
For the retrospective, case-control study, the researchers aimed to assess whether human consumption of fluoroquinolones and macrolides led to the development of antimicrobial-resistance in Campylobacter and subsequent campylobacteriosis infection.
Data were pooled from various Danish databases on all cases of campylobacteriosis that occurred between 1999 and 2005 in Denmark. Researchers compared the ORs for exposure to antimicrobial therapies before infection and the history of antimicrobial use in case patients with matched controls.
Of 31,669 confirmed cases, 21.7% were resistant against fluoroquinolones and 2.3% against macrolides.
The risk for campylobacteriosis decreased after 1 month exposure to macrolides (OR=0.72; 95% CI, 0.56-0.92). An increased odds for exposure was observed to macrolides, sulfonamides and trimethoprim, tetracyclines, and broad-spectrum penicillins, with the highest risk for fluoroquinolones, up to 1 year before campylobacteriosis diagnosis (OR=2.4; 95% CI, 1.97-2.97).
An increased risk for campylobacteriosis acquisition was observed among those with a history of fluoroquinolone use (OR=2.5; 95% CI, 1.8-3.5).
“Treatment with antibiotics may have important effects on the gut microflora,” Mølbak told Infectious Disease News. “Overuse of antimicrobials such as fluoroquinolones may lead to increased transmission of Campylobacter, in particular resistant strains. Whether the protective effect of macrolides may be applied in clinical practice is not yet known; more research is needed on that aspect in order to understand the clinical implications.” – by Ashley DeNyse
Disclosure: This work was supported by the Danish Food Industry Agency Grant No. 3304-FVFP-07-721-01.
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