Chuning Wang, Jingjing Li, Hailing Chang, He Tian, Jiehao Cai, Mingliang Chen, Zhongqiu Wei, Mei Zeng
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引用次数: 0
Abstract
Purpose: To evaluate the effectiveness and safety of oral levofloxacin verse trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment of macrolides-resistant pertussis in pediatric outpatients.
Methods: A prospective observational study was conducted at a pediatric pertussis outpatient clinic during the pertussis outbreak in 2024. For eligible children with PCR-confirmed pertussis, administration of either levofloxacin (8-10 mg/kg/dose, once or twice daily) or TMP-SMX (4-20 mg/kg/dose, twice daily) depended on parents' preference. Effectiveness and safety were evaluated for the 5-14 days duration of levofloxacin and TMP-SMX treatment in terms of alleviation of cough symptoms, bacteriologic clearance of Bordetella pertussis and adverse effects.
Results: Among 193 enrolled pertussis cases, eighty-four (43.53 %) received levofloxacin and 109 (56.48 %) received TMP-SMX. After completing treatment, paroxysmal cough resolved or improved in 96.43 % of levofloxacin group and 94.50 % (103/109) of TMP-SMX group (p = 0.554). Nocturnal cough resolved or improved in 98.81 % of levofloxacin group and in 98.17 % of TMP-SMX group (p = 0.057). There was no significant difference in bacteriologic clearance rate between levofloxacin group and TMP-SMX group determined by PCR (92.00 % vs 87.06 %, p = 0.378) and culture (100 % vs 100 %, p > 0.378). Symptom resolution rate did not differ significantly among patients treated for 5 or 7 days with either levofloxacin or TMP-SMX. Adverse events were reported in 9.2 % of TMP-SMX-treated patients and 2.4 % of levofloxacin-treated patients (p < 0.05). Drug rash was reported in nine (8.26 %) TMP-SMX-treated patients.
Conclusions: Oral levofloxacin showed a comparable clinical effectiveness and a favorable safety profile to TMP-SMX for the treatment of non-severe pertussis with a 5-7 days course in children.
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Journal of Microbiology Immunology and Infection is an open access journal, committed to disseminating information on the latest trends and advances in microbiology, immunology, infectious diseases and parasitology. Article types considered include perspectives, review articles, original articles, brief reports and correspondence.
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