Treatment: Pertussis

• Antibiotic therapy does not substantially alter the clinical course unless given early in the catarrhal phase, but is effective at eradicating the organism from the nasopharynx.
  • - Macrolides (erythromycin, 1-2 g/d for 1-2 weeks; clarithromycin, 250 mg bid for 1 week; or azithromycin, 500-mg load on day 1, then 250 mg/d for 4 days) are the drugs of choice.
  • - Trimethoprim-sulfamethoxazole (TMP-SMX; one double-strength tablet PO bid for 2 weeks) is recommended for macrolide-intolerant pts.
• Cough suppressants are ineffective and have no role in management of pertussis.
• Respiratory isolation is required for hospitalized pts until antibiotics have been given for 5 days.