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Erythromycin treatment is beneficial for longstanding Moraxella catarrhalis associated cough in children
J Darelid1, S Löfgren, B E Malmvall
1Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
Insights
Erythromycin treatment significantly improved recovery in children with persistent cough, reducing complications. Moraxella catarrhalis presence indicated prolonged illness and higher risk of bacterial issues.
Area of Science:
- Pediatrics
- Infectious Diseases
- Pharmacology
Background:
- Persistent cough in children is a common clinical problem.
- The role of specific nasopharyngeal bacteria and antibiotic treatment requires further elucidation.
Purpose of the Study:
- To analyze the benefits of antibiotic treatment and nasopharyngeal culture in children with longstanding cough.
- To investigate the impact of erythromycin and Moraxella catarrhalis on cough resolution and complications.
Main Methods:
- Prospective randomized open study excluding pertussis.
- Erythromycin treatment (7 days) versus no treatment.
- Nasopharyngeal cultures for bacterial identification (Moraxella catarrhalis, Haemophilus influenzae, Streptococcus pneumoniae).
Main Results:
- Erythromycin group: 88% recovery vs. 36% in untreated (p < 0.0001).
- Erythromycin eliminated M. catarrhalis in 68% vs. 20% spontaneous clearance (p < 0.001).
- Complications (purulent bronchitis/otitis media) reduced from 45% to 5% with treatment (p < 0.01).
- M. catarrhalis presence correlated with prolonged symptoms (p < 0.01).
Conclusions:
- Erythromycin treatment benefits children with persistent cough (>10 days).
- Nasopharyngeal M. catarrhalis indicates prolonged symptoms and increased risk of bacterial complications.
- Antibiotic therapy and pathogen identification are crucial for managing persistent cough in children.
Abstract:
The benefits of antibiotic treatment and a nasopharyngeal culture in children with longstanding cough were analysed in a prospective randomized open study. Clinically suspected pertussis was excluded. Of 40 children given erythromycin for 7 days, 35 (88%) recovered in one week, compared with 17/47 (36%) untreated (p < 0.0001). Erythromycin eliminated Moraxella catarrhalis from the nasopharynx in 21/31 children (68%), compared with spontaneous disappearance in 7/35 (20%) untreated controls (p < 0.001). Purulent bronchitis or otitis media occurred in 2 children (5%) in the treatment group and in 21 (45%) in the control group (p < 0.01). To evaluate the clinical role of isolated pathogens, the 47 untreated subjects were studied. Seven of 35 children harbouring M. catarrhalis recovered, compared with 8/12 in whom this bacterium was absent (p < 0.01). No correlation was found between the isolation of Haemophilus influenzae or Streptococcus pneumoniae and the clinical outcome. Children with persistent cough > 10 days may benefit from erythromycin treatment. M. catarrhalis in the nasopharynx indicates prolonged symptoms and increased risk of bacterial complications.
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