Charles Tubbs, MDHeli Niemi, MDDepartment of Family Practice and Community Medicine, University of Texas Southwestern, Dallas Helen G. Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) Azithromycin is as effective as and better tolerated than erythromycin estolate for the treatment of pertussis. The outcome measures used to assess the efficacy of antibiotic treatment or prophylaxis vary between the trials and most of them did not report the immunization status of the participants. Mayo, MLSUniversity of Texas Southwestern Medical Center Library, Dallas 1. Antibiotics for whooping cough (pertussis) (Cochrane Review). The Cochrane review included 1 meta-analysis of 3 studies with 252 participants, comparing azithromycin for 3 days, erythromycin estolate for 7 days, and clarithromycin for 7 days (short-term treatment) with erythromycin estolate for fourteen days (long-term treatment). Symptomatic treatment of the cough in whooping cough (Cochrane Review). A 2005 Cochrane review of 11 RCTs and 1 quasi-randomized trial, with a total of 1720 adults and children, investigated several antibiotics for treatment and prophylaxis of pertussis. The importance of counseling cannot be overstated in all dosing regimens, especially in those with a more difficult dosing schedule and in cases of prophylaxis in a household with an infant less than 6 months old. For the financially strapped, the 1-week regimen of erythromycin estolate would be preferable. Where cost is not a great issue and concerns of compliance important, choosing the short-term treatment may be a preferable option. Atlanta, Ga: Centers for Disease Control and Prevention, 2000. In an underinsured population, this out-of-pocket cost for the alternatives would prove prohibitive, resulting in decreased compliance. Pertussis has significantly increased in Australia, particularly in older children and adults. These patients do not always exhibit classical symptoms and are an important source of infection for young infants. Antibiotic treatment, isolation of index cases and timely vaccination are important strategies to prevent transmission of pertussis. Evidence of the efficacy of chemoprophylaxis for pertussis is limited. Assessing efficacy is often confounded by a delay in diagnosis of the index case. Antibiotic prophylaxis after exposure to pertussis aims to limit transmission to non-immune contacts. It is recommended for high-risk groups such as unimmunised infants, women in late pregnancy and individuals who may be a source of infection.
Departments of Microbiology and Immunology (MEP) and Pediatrics (WJH, JRC) University of Rochester Elmwood Pediatric Group (MEP, WJH, JRC) Rochester, NY Accepted for publication May 8, 2003. The patients were otherwise in good health and without obvious cause for their cough syndrome other than possible (Zithromax; Pfizer) 10 mg/kg on Day 1 followed by 5 mg/kg/day once daily for the following 4 days (maximum dose 1000 mg on Day 1 and 500 mg on Days 2 to 5). D., Department of Microbiology/Immunology, University of Rochester Medical Center, 601 Elmwood Ave., Box 672, Rochester, NY 14642. , defined as cough lasting 7 to 14 days and one of the following: (1) paroxysmal cough; (2) cough ending in vomiting; or (3) inspiratory whoop. The drugs were provided in suspension or tablet according to the preference of the subject at no charge, and all were instructed how to take the medication by the study nurse. culture and PCR analysis was taken from each subject at entry into the study and on Days 2 to 3 and 14 to 21. Medication compliance and adverse events were assessed during study visits. Adverse events, defined as any undesirable experience occurring in a subject during the clinical trial considered related to the investigational drug, were recorded throughout the study. Compliance was evaluated by bottle weight, pill counts and subject diary. Infants who have not yet completed the National Immunisation Schedule and children who are not immunised, or only partially immunised, are most at risk from pertussis. The best way to protect at-risk individuals is on-time vaccination, as it protects against infection and reduces the number of people in the community that can transmit the bacteria. Infants who have not yet completed the National Immunisation Schedule and children who are not immunised, or only partially immunised are most at risk from pertussis. The best way to protect at-risk individuals is on-time vaccination, as it protects against infection for infants who are at highest risk and reduces the number of people in the community that can transmit the bacteria. Pertussis booster vaccinations in the combination Tdap vaccine are fully-subsidised as of January, 2013 for pregnant women between 28 – 38 weeks gestation Figure 1 shows pertussis hospitalisations by calendar month since 1998. Infants aged under one year are at the greatest risk of severe disease and account for over 60% of the hospitalisations that have occurred since the latest outbreak began in August 2011.2 Health professionals can reduce severe pertussis infection rates by recommending on-time vaccination for all infants and children, and booster vaccinations for women who are pregnant and adults with regular contact with infants. The minimum dose-interval is four weeks and the first dose is not recommended before age six weeks.
May 10, 2013. Pertussis halting the epidemic by protecting infants. Azithromycin is first-line for treatment and prophylaxis of pertussis in infants and children. Antibiotic treatment of pertussis and judicious use of antimicrobial agents for postexposure prophylaxis will eradicate B. pertussis from the nasopharynx of infected persons symptomatic or asymptomatic.