When should I consider referring a patient with Campylobacter gastroenteritis to secondary care?

Consider referring a patient with Campylobacter gastroenteritis to secondary care if any of the following apply:

• There are symptoms or signs suggesting severe dehydration or shock, such as altered consciousness, cold extremities, or decreased urine output.
• There is blood and/or mucus in the stool, which may indicate a more severe or complicated infection.
• The patient is immunocompromised or malnourished, increasing the risk of complications.
• The patient is very young (for example, under 6 months old) with salmonella gastroenteritis or similar bacterial infections, as antibiotic treatment may be required.
• There is suspicion of septicaemia or extra-intestinal spread of infection.
• The patient has persistent symptoms beyond 7 days or worsening clinical condition despite initial management.
• Social circumstances make remote assessment or home management unreliable.

In these cases, urgent or emergency transfer to secondary care should be arranged for further assessment and management, including intravenous fluids and possible antibiotic therapy if indicated.

For most patients with uncomplicated Campylobacter gastroenteritis, management in primary care with supportive care and oral rehydration is appropriate.

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