title: Erythromycin treatment is beneficial for longstanding Moraxella catarrhalis associated cough in children.
abstract: The benefits of antibiotic treatment and a nasopharyngeal culture in children with longstanding cough were analysed in a prospective randomized open study. Clinically suspected pertussis was excluded. Of 40 children given erythromycin for 7 days, 35 (88%) recovered in one week, compared with 17/47 (36%) untreated (p < 0.0001). Erythromycin eliminated Moraxella catarrhalis from the nasopharynx in 21/31 children (68%), compared with spontaneous disappearance in 7/35 (20%) untreated controls (p < 0.001). Purulent bronchitis or otitis media occurred in 2 children (5%) in the treatment group and in 21 (45%) in the control group (p < 0.01). To evaluate the clinical role of isolated pathogens, the 47 untreated subjects were studied. Seven of 35 children harbouring M. catarrhalis recovered, compared with 8/12 in whom this bacterium was absent (p < 0.01). No correlation was found between the isolation of Haemophilus influenzae or Streptococcus pneumoniae and the clinical outcome. Children with persistent cough > 10 days may benefit from erythromycin treatment. M. catarrhalis in the nasopharynx indicates prolonged symptoms and increased risk of bacterial complications.
authors.affiliation: Department of Infectious Diseases, Ryhov Hospital, Jönköping, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Darelid
authors.forename: S
authors.initials: S
authors.lastname: Löfgren
authors.forename: B E
authors.initials: BE
authors.lastname: Malmvall
mesh_terms: D002648:Child; D002675:Child, Preschool; D003371:Cough / Q000188:drug therapy* / Q000382:microbiology; D004917:Erythromycin / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D007223:Infant; D001936:Moraxella catarrhalis / Q000187:drug effects* / Q000302:isolation & purification; D009305:Nasopharynx / Q000382:microbiology; D016870:Neisseriaceae Infections / Q000188:drug therapy* / Q000382:microbiology; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D004917:Erythromycin