PICHICHERO ME, CASEY JR, HOEGER WJ; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. G-458.
University of Rochester, Rochester, NY.
BACKGROUND: Our objectives were to assess the efficacy of a 5-day course of azithromycin in children and their parents with pertussis; and to evaluate disease morbidity and work productivity during illness. METHODS: Children and their parents presenting with a clinically defined pertussis syndrome were eligible for study. Patients received azithromycin 10 mg/kg/day on day 1, then 5 mg/kg/day for the next 4 days for a maximum of 1000 mg on day 1 and 500 mg on day 2-5. Nasopharyngeal (NP) specimens for culture and polymerase chain reaction (PCR) testing and serology for Bordetella pertussis were evaluated at enrollment and at day 2-3 and/or 14-21 after enrollment. Clinical assessments and adverse event solicitation occurred at all visits. RESULTS: 121 subjects were enrolled with clinical pertussis. 29 subjects were culture positive, 5 additional subjects were PCR positive and 55 additional subjects were serology positive for B pertussis infection for a total of 89 laboratory-confirmed cases. The median age of the 121 subjects was 8.5 years; mean = 13 +/- 12 years (range = 6 months to 47 years). Eradication of B pertussis from the NP occurred in 33 (97%) of 34 culture/PCR positive patients by day 2-3 of azithromycin treatment; 100% were culture/PCR negative at the 14-21 day follow-up visit. Adverse events occurred in 14 (12%) subjects (all mild gastrointestinal) and compliance with the medication regimen was high. Median number of days of cough before diagnosis was 9; after starting treatment it took a median of 9 days before subjects reported clinical improvement. The median number of days to full recovery was 32 days; mean = 28 +/- 19 days (range = 5-90 days). 67 adults reported missing work a mean = 3 +/- 2 days; for those who did work productivity was below 100% for 48%. CONCLUSIONS: A 5-day course of azithromycin appears effective for rapid eradication of pertussis. Even so, the prolonged cough of pertussis causes considerable morbidity and loss of work productivity.
Publication Types:
Keywords:
- Adult
- Azithromycin
- Bordetella pertussis
- Child
- Cough
- Humans
- Morbidity
- Nasopharynx
- Pertussis Vaccine
- Physical Examination
- Polymerase Chain Reaction
- Serologic Tests
- Whooping Cough
- methods
Other ID:
UI: 102265970
From Meeting Abstracts