Problems associated with prophylactic use of erythromycin in 1566 staff to prevent hospital infection during the outbreak of pertussis.
OBJECTIVE
Pertussis developed in Kagawa University Medical School and University Hospital in May 2007. To control the outbreak and prevent the infection of hospital inpatients, the Infection Control Team (ICT) carried out the prophylactic administration of erythromycin (EM) to hospital staff (1566 staff) who might be exposed to Bordetella pertussis.


METHODS
An oral dose of 1000 mg/day EM was given for 10 days. To assess compliance and estimate the frequency of adverse effect, the ICT conducted a questionnaire survey.


CONCLUSIONS
Of 942 respondents (response rate: 60.2%), 264 (28.0%) experienced some form of EM adverse effects, of which the most commonly reported involved digestive organ symptoms, e.g. diarrhoea (15.6%), stomachache (7.5%), nausea (3.6%), epigastric distress (2.1%) and abdominal distention (1.8%). More importantly, 246 participants (26.1%) stopped taking the EM before completing 10 days because of perceived adverse effects.


CONCLUSIONS
These results indicate that EM appears to cause adverse effects more frequently than reported in the package insert in Japan. The prophylactic use of EM for pertussis infection is recognized in the guideline of the Centers for Disease Control and Prevention. However, this study suggests that attention should be paid to EM non-compliance during a pertussis outbreak, which could extend the duration of the outbreak and increase the number of affected patients.
Tanaka
H
H
Department of Pharmacy, Kagawa University Hospital, Miki-cho, Kita-gun, Kagawa, Japan. tanahiro@med.kagawa-u.ac.jp
Kaji
M
M
Higuchi
K
K
Shinohara
N
N
Norimatsu
M
M
Kawazoe
H
H
Ninomiya
M
M
Fukuoka
N
N
Ishii
N
N
Fujita
J
J
Okabe
A
A
Houchi
H
H
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D003428:Cross Infection / Q000517:prevention & control*; D004196:Disease Outbreaks; D004917:Erythromycin / Q000009:adverse effects*; D006801:Humans; D014917:Whooping Cough / Q000453:epidemiology*
D000900:Anti-Bacterial Agents; D004917:Erythromycin