management of pertussis

Management of Pertussis:

The disease can be recognised in two different states, catarrhal stage (which is where the patient is most infectious) or paroxysmal stage (which is where the characteristic paroxysms of coughing begin, about a week after catarrhal stage). The stage in which it is diagnosed will affect the method of treatment. If Pertussis is diagnosed in the catarrhal stage then treatment involves erythromycin (a type of antibiotic which slows the growth of and can sometimes kill bacteria), which will decrease the severity of the disease. If the disease is diagnosed in the paroxysmal stage then antibiotics have a very small role in altering the course of the illness. In some cases intravenous pertussis immune globulin therapy has been shown to decrease whooping, to improve oxygen saturation and to stop bradicardic episodes. Membrane oxygenation is widely used in the management of severe pertussis, but it has had limited success, and pertussis severe enough to require its use is in itself a predictor of a poor outcome. Affected individuals should be isolated to prevent the disease spreading.

References: http://www.cmaj.ca/cgi/content/full/172/4/509
http://www.drugs.com/erythromycin.html
Kumar and Clark

(Monica Abadier)