This patient, who has spontaneous symptom resolution of Campylobacter jejuni infection, requires no further evaluation or treatment. Treatment of bacterial dysentery is controversial; most cases resolve spontaneously, but, in the case of Salmonella gastroenteritis, antibiotics may actually prolong bacterial shedding. However, when patients are at risk for extraintestinal complications because of advanced age or immunocompromise, or when symptoms are particularly severe, the benefits of empiric treatment outweigh the risks. For most causes of dysentery, fluoroquinolones, such as levofloxacin, are considered first-line therapy based on limited resistance to most bacterial agents. The exception is Campylobacter, which a recent study documented 14% fluoroquinolone resistance in domestically acquired infections and greater than 50% link to international travel. Consumption of undercooked poultry may raise suspicion for Campylobacter infection, but symptoms substantially overlap among the various agents causing dysentery; culture is required to identify the causative agent. Despite treatment with an antibiotic to which the organism was resistant, symptoms completely resolved by the time the culture results were finalized. This underscores the fact that in most cases of bacterial gastroenteritis, infection resolves spontaneously without therapy, and further evaluation or treatment is unnecessary.

Blood cultures are appropriate if symptoms worsen and the patient is at risk for sepsis and extraintestinal infections. However, because this patient's symptoms have resolved, blood cultures would be inappropriate.

Asymptomatic excretion of Campylobacter can persist for several weeks following resolution of symptoms; however, person-to-person transmission is uncommon, and surveillance stool cultures are not recommended to document clearance. Considering the patient's occupation, strict attention to hand hygiene would be important to minimize risk for secondary spread.

Macrolides are the preferred treatment for Campylobacter infection. This would be an appropriate choice if symptoms had persisted.

Ciprofloxacin would not be a viable option after resistance to levofloxacin is confirmed. Campylobacter bacteria resistant to levofloxacin are likely to be resistant to other fluoroquinolones as well.