Chuning Wang, Jingjing Li, Hailing Chang, He Tian, Jiehao Cai, Mingliang Chen, Zhongqiu Wei, Mei Zeng
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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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":56117,"journal":{"name":"Journal of Microbiology Immunology and Infection","volume":" ","pages":""},"PeriodicalIF":3.7000,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Levofloxacin is as effective as trimethoprim-sulfamethoxazole for the treatment of pertussis: A prospective observational study.\",\"authors\":\"Chuning Wang, Jingjing Li, Hailing Chang, He Tian, Jiehao Cai, Mingliang Chen, Zhongqiu Wei, Mei Zeng\",\"doi\":\"10.1016/j.jmii.2025.08.023\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To evaluate the effectiveness and safety of oral levofloxacin verse trimethoprim-sulfamethoxazole (TMP-SMX) for the treatment of macrolides-resistant pertussis in pediatric outpatients.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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). 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引用次数: 0
摘要
目的：评价口服左氧氟沙星与甲氧苄啶-磺胺甲恶唑（TMP-SMX）治疗儿科门诊大环内酯耐药百日咳的有效性和安全性。方法：在2024年百日咳爆发期间在儿科百日咳门诊进行前瞻性观察研究。对于经pcr证实的符合条件的百日咳患儿，根据家长的喜好，给予左氧氟沙星（8- 10mg /kg/剂，每日1次或2次）或TMP-SMX （4- 20mg /kg/剂，每日2次）。从缓解咳嗽症状、百日咳杆菌的细菌清除率和不良反应方面评估左氧氟沙星和TMP-SMX治疗5-14天的有效性和安全性。结果：193例百日咳患者中，84例（43.53%）接受左氧氟沙星治疗，109例（56.48%）接受TMP-SMX治疗。治疗结束后，左氧氟沙星组止咳率为96.43%，TMP-SMX组止咳率为94.50% (103/109)（p = 0.554）。左氧氟沙星组和TMP-SMX组夜间咳嗽缓解或改善率分别为98.81%和98.17% （p = 0.057）。PCR检测左氧氟沙星组与TMP-SMX组的细菌清除率（92.00 % vs 87.06%, p = 0.378）和培养组（100% vs 100%, p = 0.378）差异无统计学意义。在左氧氟沙星或TMP-SMX治疗5天或7天的患者中，症状缓解率无显著差异。结果表明：口服左氧氟沙星治疗儿童非重度百日咳的临床疗效和安全性与TMP-SMX相当，疗程为5-7天。
Levofloxacin is as effective as trimethoprim-sulfamethoxazole for the treatment of pertussis: A prospective observational study.
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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