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Current practices of adjunctive therapy for pertussis at six Canadian tertiary care pediatric hospitals
1Departments of Pediatrics, Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia.
Insights
Pediatric pertussis (whooping cough) management varied significantly across Canadian hospitals. Treatment often deviated from national guidelines, highlighting a need for standardized care for this infectious respiratory illness.
Area of Science:
- Pediatric Infectious Diseases
- Respiratory Medicine
- Public Health
Background:
- Pertussis remains a significant concern in pediatric populations.
- Hospitalization for pertussis necessitates specific management protocols.
Purpose of the Study:
- To document the initial investigations and treatments for hospitalized children diagnosed with pertussis.
- To assess adherence to national treatment recommendations in Canadian pediatric hospitals.
Main Methods:
- Retrospective chart review of 440 children admitted with pertussis across six Canadian pediatric hospitals between 1991 and 1995.
- Data collected included diagnostic methods, prescribed medications, and patient outcomes.
Main Results:
- Bordetella pertussis cultures were frequently positive, with significant inter-hospital variability.
- Erythromycin was common, but only 47% received the recommended dosage.
- Salbutamol and corticosteroids were used for reactive airways disease, associated with longer hospital stays in younger children.
Conclusions:
- Significant variation exists in pertussis treatment protocols among Canadian pediatric facilities.
- Current treatment practices often did not align with established Canadian recommendations.
- Findings provide a national perspective and baseline for future pertussis management studies.
Objective:
To document initial investigations and treatment used in the management of children hospitalized with pertussis.
Design:
Retrospective chart review encompassing admissions from January 1, 1991 to June 1, 1995.
Setting:
Six Canadian pediatric hospitals representing about 39% of the pediatric tertiary care beds in Canada.
Patients:
Four hundred and forty children who met the inclusion criterion of a primary admitting diagnosis of pertussis and who did not meet the exclusion criterion of nosocomially acquired pertussis or a prior admission for pertussis during the study period.
Main Results:
Most patients had cultures positive for Bordetella pertussis, although the proportion of positive tests varied widely among hospitals. Erythromycin was the most commonly used medication; however, only 47% of children received the recommended dosage. Salbutamol and corticosteroids were used most often in patients with reactive airways disease. Younger children and those with reactive airways disease had longer lengths of stay in hospital.
Conclusions:
Pertussis treatment varied widely among the six hospitals studied, and was often not consistent with current Canadian recommendations. The results will allow practitioners to place their practices in a national perspective and provide a baseline for further studies.
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