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Clarithromycin in the treatment of pertussis in children: results of a randomized controlled trial

Pertussis is still a fairly common infectious disease and a public health problem. Erythromycin is an antibacterial drug recommended for the treatment and prevention of pertussis, however, adverse reactions to the drug erythromycin limit its use in some patients. Clarithromycin has a pronounced activity against Bordetella pertussis in vitro and is better tolerated.

The aim of a prospective, randomized, simple and blind study conducted by Canadian scientists was to compare the microbiological and clinical efficacy and the clinical safety of a 7-day clarithromycin treatment compared to a erythromycin treatment. 14 days in children with pertussis.

The study involved children aged 1 month to 16 years with a clinical diagnosis of pertussis. Patients were randomized into 2 groups: the first (76 children) received 7.5 mg / kg of clarithromycin x twice daily for 7 days, the second (77 children) received erythromycin (13.3 mg / kg x 3 times a day) within 14 days). A microbiological examination was carried out at the time of inclusion in the study and at the end of treatment. In the patients included, Bordetella pertussis was isolated from 62 patients (35 patients from the first group and 27 from the second group).

The clinical efficacy and microbiological eradication of the pathogen were 100% in the group receiving clarithromycin and 96% in the group receiving erythromycin. In the clarithromycin group, the incidence of adverse drug reactions was significantly lower than in the erythromycin group (45% vs 62%, p = 0.035), and compliance in patients receiving clarithromycin was significantly higher.

Thus, a 7-day course of clarithromycin and a 14-day course of erythromycin are also effective in the treatment of whooping cough, but clarithromycin is better tolerated.