Antibiotic prophylaxis of pertussis

Altunaiji S, et al. Antibiotics for whooping cough (pertussis). Cochrane Database Syst Rev. 2007 Jul 18;(3):CD004404. (Edited (no change to conclusions), comment added to review in Issue 3, 2013.)

“This systematic review of RCTs examining the treatment of whooping cough has found that antibiotic treatment is effective in eliminating B. pertussis from the nasopharynx and thus rendering participants non-infectious, but does not alter the clinical course of the illness. Prophylaxis with antibiotic was significantly associated with side effects; it did not significantly improve clinical symptoms, prevent the development of culture-positive B. pertussis, nor paroxysmal cough for more than two weeks, in contacts older than six months of age.”

Full-text for Children’s and Emory users.

Continue reading

Practice Based Learning: Which infants with ALTE should be tested for pertussis?

Palen Mallory, MD

Presented by Palen Mallory, MD

Key Points:

  • Positive predictors for infection with Bordatella pertussis:

–  age <2mos

–  presentation July-October

–  less tachypnea

–  Leukocytosis

–  Lymphocytosis

  •  Indications for isolation and testing for pertussis:

–  Parental report of cyanosis/turning blue or purple with cough or choking episode

–  Age under 2 months

–  Cough on physical exam

–  Rhonchi on physical exam

References:

Fu, L., & Moon, R. (2012). Apparent Life-Threatening Events: An Update. Pediatrics in Review, 33(8), 361-367.

Guinto-Ocampo, H. et al (2008). Predicting Pertussis in Infants. Pediatric Emergency Care, 24(1), 16-20.

Mackey, J. et al(2007). Predicting Pertussis in a Pediatric Emergency Department Population. Clinical Pediatrics, 46(5), 437-440.

Tintinalli, J. et al (2010). Tintinalli’s Emergency Medicine (7 ed.). f: The McGraw-Hill Companies.