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Antibiotic treatment of pertussis: are 7 days really sufficient?
Alexa Dierig1, Christiane Beckmann, Ulrich Heininger
1From the *Division of Pediatric Infectious Diseases, University Children's Hospital Basel, Basel, Switzerland; †Division of Infection Diagnostics, Department Biomedicine (Haus Petersplatz), University of Basel, Basel, Switzerland; and ‡University of Basel, Basel, Switzerland.
Insights
Short courses of antibiotic therapy for pertussis may not be sufficient for young infants. Two unvaccinated infants remained positive for Bordetella pertussis after multiple antibiotic treatments, challenging current guidelines.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Pertussis, or whooping cough, is a highly contagious respiratory infection.
- Short-course antibiotic therapy is the standard treatment for pertussis.
- Current guidelines suggest contagiousness decreases significantly after 5 days of antibiotics.
Abstract:
Short courses of antibiotic therapy are recommended for treatment of pertussis. We report 2 young unvaccinated infants with persistently positive Bordetella pertussis by polymerase chain reaction from nasopharyngeal swabs despite 7 days of clarithromycin (15 mg/kg/d) therapy. In 1 patient, quantitative polymerase chain reaction was 7.02 (log GEq/mL) at the onset of treatment, 6.26 at the end of treatment and remained positive with 2.64 and 2.69 during and after a second 7-day course, respectively. The generally believed assumption that contagiousness of pertussis is terminated after 5 days of antibiotic treatment should be challenged, at least in young infants.
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