Antibiotics for Whooping Cough (pertussis)

Overview

Journal Cochrane Database Syst Rev

Publisher Wiley

Specialties General Medicine
Health Services

Date 2007 Jul 20

PMID 17636756

Citations 38

Authors

S Altunaiji

R Kukuruzovic

N Curtis

J Massie

Affiliations

Soon will be listed here.

Abstract

Background: Whooping cough is a highly contagious disease. Infants are at highest risk of severe disease and death. Erythromycin for 14 days is currently recommended for treatment and contact prophylaxis, but is of uncertain benefit.

Objectives: To study the benefits and risks of antibiotic treatment of and contact prophylaxis against whooping cough.

Search Strategy: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library Issue 1, 2007); MEDLINE (January 1966 to March 2007); EMBASE (January 1974 to March 2007).

Selection Criteria: All randomised and quasi-randomised controlled trials of antibiotics for treatment of, and contact prophylaxis against, whooping cough.

Data Collection And Analysis: Three to four review authors independently extracted data and assessed the quality of each trial.

Main Results: Thirteen trials with 2197 participants met the inclusion criteria: 11 trials investigated treatment regimens; 2 investigated prophylaxis regimens. The quality of the trials was variable.Short-term antibiotics (azithromycin for three to five days, or clarithromycin or erythromycin for seven days) were as effective as long-term (erythromycin for 10 to 14 days) in eradicating Bordetella pertussis (B. pertussis) from the nasopharynx (relative risk (RR) 1.02, 95% confidence interval (CI) 0.98 to 1.05), but had fewer side effects (RR 0.66, 95% CI 0.52 to 0.83). Trimethoprim/sulfamethoxazole for seven days was also effective. Nor were there differences in clinical outcomes or microbiological relapse between short and long-term antibiotics. Contact prophylaxis of contacts older than six months of age with antibiotics did not significantly improve clinical symptoms or the number of cases developing culture-positive B. pertussis.

Authors' Conclusions: Although antibiotics were effective in eliminating B. pertussis, they did not alter the subsequent clinical course of the illness. There is insufficient evidence to determine the benefit of prophylactic treatment of pertussis contacts.

Citing Articles

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Real-Life Insights into Pertussis Diagnosis: High Yield of PCR Testing and Clinical Outcomes-An Emerging Old Enemy or Just a Sign of PCR Times?.

Dimeas I, Kotsiou O, Salgkami P, Poulakida I, Boutlas S, Daniil Z J Pers Med. 2024; 14(12).

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Working group summary of the 2023 full update of the Finnish national guidelines for paediatric lower respiratory tract infections.

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The Chaperonin TRiC/CCT Inhibitor HSF1A Protects Cells from Intoxication with Pertussis Toxin.

Jia J, Zoeschg M, Barth H, Pulliainen A, Ernst K Toxins (Basel). 2024; 16(1).

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Inhibition of Pertussis Toxin by Human α-Defensins-1 and -5: Differential Mechanisms of Action.

Kling C, Sommer A, Almeida-Hernandez Y, Rodriguez A, Perez-Erviti J, Bhadane R Int J Mol Sci. 2023; 24(13).

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