Staying ahead of pertussis
In recent years, pertussis has been on the rise. Here’s what you can do to help limit the spread of the disease, and how to promptly diagnose and treat it.
A macrolide antibiotic is generally used to treat pertussis (TABLE 4).25-30 Erythromycin had been the drug of choice, but recent studies have found similar efficacy for azithromycin and clarithromycin.29 For infants younger than one month of age, azithromycin is preferred because in addition to being as effective as other macrolides, it has a better adverse effect profile.29 For patients who are at least 2 months of age, trimethoprim-sulfamethoxazole is an acceptable alternative to a macrolide.
The CDC recommends that any adolescent or adult who has a cough and has had close contact with an individual with a laboratory-confirmed case of pertussis within the past 21 days should be treated.30 Close contacts younger than 7 years of age who have not received the first 4 doses of the pertussis vaccine should be offered treatment.
CORRESPONDENCE
Gary Rivard, DO, Family Medicine Residency Program, Central Maine Medical Center, 76 High Street, Lewiston, ME 04282; rivardga@cmhc.org
