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Updated: Jul 23, 2026

Sublingual Immunotherapy as an Alternative to Induce Protection Against Acute Respiratory Infections
Published on: August 30, 2014
[Antibiotic therapy in children with pertussis]
Insights
Antibiotics like erythromycin are effective for early pertussis (whooping cough) treatment in infants. However, antibiotics do not prevent later complications and may increase risks when used during the spastic phase.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Context:
- Pertussis (whooping cough) treatment guidelines require updates based on recent data.
- Antibiotic therapy aims to prevent Bordetella pertussis colonization in the respiratory tract.
Purpose:
- To compare the efficacy of erythromycin and ampicillin in infants with pertussis during the first two weeks of illness.
- To evaluate the preventative effect of antibiotic therapy during the spastic phase of pertussis on bronchopulmonary complications.
Summary:
- Erythromycin demonstrated superior therapeutic activity and fewer side effects compared to ampicillin in infants under one year old during the initial two weeks of pertussis.
- Antibiotic use during the spastic period of pertussis did not prevent secondary bacterial complications; instead, prophylactic antibiotic use led to a 2.6-fold increase in complications, including hospital-acquired pneumonia.
Impact:
- Antibiotic selection for pertussis should prioritize efficacy and safety, with erythromycin being a preferred choice in early stages.
- Current evidence suggests against the prophylactic use of antibiotics in later stages of pertussis to prevent secondary bacterial infections, as it may be counterproductive.
Abstract:
The data accumulated within the last years required revision of the indications to the use of antibiotics in treatment of pertussis. One of the aims of antibiotic therapy in pertussis was to prevent colonization of B. pertussis in the respiratory tracts. With that end in view the choice of antibiotics should be limited by those, to which the pathogen is the most sensitive i.e. erythromycin, ampicillin and augmentin. Comparative efficacy of erythromycin and ampicillin during the first 2 weeks of the disease was studied in 79 infants at the age not older than 1 year with pertussis and it was shown that erythromycin was advantageous by its therapeutic activity and less side effects. Expedience of the antibiotic therapy during the spastic period for providing a preventive effect on development of bronchopulmonary complications was studied in 201 patients with pertussis. No preventive effect of the antibiotics on development of the bronchopulmonary complications defined by the secondary bacterial flora was recorded. In the group of the patients treated with the antibiotics prophylactically (group 1) the complications were 2.6 times more frequent than in the patients treated with pathogenetic agents alone (group 2). Intrahospital pneumonia developed in 8.9 per cent of the patients in group 1 and in 1.5 per cent of the patients in group 2. Therefore, antibiotics should not be used at the late periods of pertussis for prophylaxis of secondary bacterial complications.
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