Abstract
BackgroundErythromycin has traditionally been the choice for prophylaxis and treatment of pertussis, but recently azithromycin has been recommended as another first-line agent. We evaluated treatment adherence between exposed persons giving erythromycin or azithromycin during a community-wide pertussis outbreak. MethodsThis was a case-control study. All cases and their contacts were prescribed either 56 doses of erythromycin over 14days or 5 doses of azithromycin over 5days. A standardized questionnaire regarding demographics, side effects, and compliance with therapy was administered by mail or telephone interviews. ResultsOf 244 persons prescribed erythromycin, 139 (57%) completed the full course compared with 234 (93%) of 251 persons prescribed azithromycin (rate ratio [RR] 4.5; 95% confidence interval [CI], 2.9–7.0). The primary reason for not completing erythromycin was side effects in 79 (76%) persons, of whom 72 (91%) reported gastrointestinal upset, compared with azithromycin side effects in 6 (35%) of whom 5 (83%) reported gastrointestinal side effects. ConclusionsAzithromycin was associated with significantly higher completion rates than erythromycin. Due to side effects, the use of azithromycin may be preferable to erythromycin in outbreaks of pertussis.
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