Antibiotics for whooping cough (pertussis).

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Whooping cough (pertussis) is a highly contagious bacterial infection, posing the greatest risk of severe illness and death to infants.
• Current recommendations for treatment and prophylaxis involve a 14-day course of erythromycin, with uncertain efficacy.

Purpose of the Study:

• To evaluate the benefits and risks associated with antibiotic treatment for whooping cough.
• To assess the effectiveness of antibiotic contact prophylaxis in preventing pertussis.

Main Methods:

• A systematic review of randomized and quasi-randomized controlled trials was conducted.
• Searches included major databases like CENTRAL, DARE, MEDLINE, and EMBASE up to March 2007.
• Data extraction and quality assessment were performed independently by multiple reviewers.

Main Results:

• Short-term antibiotic regimens (e.g., azithromycin for 3-5 days, clarithromycin or erythromycin for 7 days) were as effective as long-term erythromycin (10-14 days) in eliminating Bordetella pertussis (B. pertussis) from the nasopharynx.
• Short-term antibiotics demonstrated fewer side effects compared to longer durations.
• Antibiotic treatment did not significantly alter the clinical course of whooping cough or prevent relapse.
• Antibiotic prophylaxis for contacts over six months of age did not significantly reduce clinical symptoms or culture-positive B. pertussis cases.

Conclusions:

• While antibiotics effectively clear B. pertussis, they do not influence the subsequent clinical progression of whooping cough.
• Evidence regarding the benefit of prophylactic antibiotic treatment for pertussis contacts is currently insufficient.