• Cochrane Db Syst Rev · Jul 2007

    Review Meta Analysis

    Antibiotics for whooping cough (pertussis).

    • S Altunaiji, R Kukuruzovic, N Curtis, and J Massie.
    • Zayed Military Hospital, Paedatrics Department, PO Box 12898, Aldhaid, Sharjah, United Arab Emirates. altunaiji1@gmail.com
    • Cochrane Db Syst Rev. 2007 Jul 18; 2007 (3): CD004404CD004404.

    BackgroundWhooping cough is a highly contagious disease. Infants are at highest risk of severe disease and death. Erythromycin for 14 days is currently recommended for treatment and contact prophylaxis, but is of uncertain benefit.ObjectivesTo study the benefits and risks of antibiotic treatment of and contact prophylaxis against whooping cough.Search StrategyWe searched the Cochrane Central Register of Controlled Trials (CENTRAL), the Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library Issue 1, 2007); MEDLINE (January 1966 to March 2007); EMBASE (January 1974 to March 2007).Selection CriteriaAll randomised and quasi-randomised controlled trials of antibiotics for treatment of, and contact prophylaxis against, whooping cough.Data Collection And AnalysisThree to four review authors independently extracted data and assessed the quality of each trial.Main ResultsThirteen trials with 2197 participants met the inclusion criteria: 11 trials investigated treatment regimens; 2 investigated prophylaxis regimens. The quality of the trials was variable.Short-term antibiotics (azithromycin for three to five days, or clarithromycin or erythromycin for seven days) were as effective as long-term (erythromycin for 10 to 14 days) in eradicating Bordetella pertussis (B. pertussis) from the nasopharynx (relative risk (RR) 1.02, 95% confidence interval (CI) 0.98 to 1.05), but had fewer side effects (RR 0.66, 95% CI 0.52 to 0.83). Trimethoprim/sulfamethoxazole for seven days was also effective. Nor were there differences in clinical outcomes or microbiological relapse between short and long-term antibiotics. Contact prophylaxis of contacts older than six months of age with antibiotics did not significantly improve clinical symptoms or the number of cases developing culture-positive B. pertussis.Authors' ConclusionsAlthough antibiotics were effective in eliminating B. pertussis, they did not alter the subsequent clinical course of the illness. There is insufficient evidence to determine the benefit of prophylactic treatment of pertussis contacts.

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