Selection of an erythromycin for the treatment of pertussis

Pertussis is one of the most communicable diseases of the respiratory tract and the incidence of this disease has increased substantially in recent years. Bordetella pertussis is the major pathogen implicated and erythromycin is considered the drug of choice. Because more studies have reported bacteriological and clinical relapses with ethylsuccinate and stearate formulations than with the estolate preparation, erythromycin estolate 50 mg/kg/d in divided doses over a 14-day period is recommended for the treatment of pertussis. None of the studies, however, have directly compared various forms of erythromycin in these patients to establish superiority of one form over the others. Treatment should be initiated as soon as possible and patients should be followed closely to achieve maximal efficacy and minimize the spread of the disease.