Antibiotics and pertussis.

Antibiotics and pertussis. Antibiotic treatment is the best way for controlling pertussis. Antimicrobi al agents given during the catarrhal stage may improve the disease and redu ce the spread. Afterward, (paroxysm stage) antibiotics are still indicated to decrease infectivity and limit contagiousness. The indications of antibi otic prophylaxis for households and close contacts should be wide, irrespec tive of age or immunization states, because pertussis immunity is not absol ute. Erythromycin given every 6 hours for 14 days remains the gold standard . Other macrolide compounds that are better tolerated (spiramycin, josamyci n , roxithromycin, clarithromycin and romycin) have pharmacokinetic/pharmac odynamic parameters suggesting good clinical efficacy. Alternatives to macr olide agents are trimethoprim-sulfamethoxazolo and for adult patients quino lones. (C) 2001 Editions scientifiques et medicales Elsevier SAS.