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Evidence summaries

Antibiotics for Whooping Cough (Pertussis)

Antibiotics are effective in eliminating Bordetella pertussis from patients with whooping cough but do not alter the subsequent clinical course of the illness. Preferred regimens are three or five days of azithromycin or seven days of clarithromycin. There is insufficient evidence to determine the benefit of prophylactic treatment of contacts older than six months of age. Level of evidence: "A"

A Cochrane review [Abstract] 1 included 13 studies with a total of 2 197 subjects. 11 trials investigated treatment regimens and two investigated prophylaxis regimens. The quality of the trials was variable.

Short-term antibiotics (azithromycin for three to five days, clarithromycin for seven days, or erythromycin estolate for seven days) were equally effective with long-term antibiotic treatment (erythromycin estolate or erythromycin for 14 days) in the microbiological eradication of Bordetella pertussis (B. pertussis) from the nasopharynx. The RR was 1.01 (95% CI 0.98 to 1.04). Side effects were fewer with short-term treatment (RR 0.66; 95% CI 0.52 to 0.83). There were no differences in clinical improvement or microbiological relapse between short and long-term treatment regimens. Contact prophylaxis (of contacts older than six months of age) with antibiotics did not significantly improve clinical symptoms or the number of cases that developed culture positive B. pertussis.

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References

  • Altunaiji S, Kukuruzovic R, Curtis N, Massie J. Antibiotics for whooping cough (pertussis). Cochrane Database Syst Rev 2007 Jul 18;(3):CD004404 [Review content assessed as up-to-date: 17 January 2011]. [PubMed]

Primary/Secondary Keywords