Erythromycin in whooping cough

doi:10.1136/bmj.b2615

Published 29 June 2009, doi:10.1136/bmj.b2615
Cite this as: BMJ 2009;338:b2615

Letters

Whooping cough

Erythromycin in whooping cough

The first 150 words of the full text of this article appear below.

Erythromycin is no longer considered the first choice in contactprophylaxis for whooping cough.¹ According to a Cochrane review,²the best regimens for microbiological clearance and for contactprophylaxis, with fewer side effects, are azithromycin (10 mg/kgas a single dose for three days or 10 mg/kg on the $fi$ rst day and5 mg/kg once daily for four days) or clarithromycin (7.5 mg/kgtwice daily for seven days). The 2002 UK guidelines cited byHarnden advised against using newer macrolides since they werenot licensed,³ but these drugs are now included in the 2008BNF for children for preventing secondary cases of pertussisin non-immune or partially immune patients. Moreover, infantsexposed to erythromycin (but not other macrolides) are at greaterrisk of developing hypertrophic pyloric stenosis.⁴

Although the polymerase chain reaction is not a basic test,it may be decisive and quick in determining when serology isnot useful, . . . [Full text of this article]

Gianluca Tornese, resident in paediatrics¹, Federica Patarino, resident in paediatrics¹, Federico Marchetti, consultant paediatrician¹

¹ Department of Paediatrics, Institute of Child Health, IRCCS Burlo Garofolo, and University of Trieste, Trieste, Italy

gianluca.tornese@gmail.com