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Treatment of the cough in whooping cough

Bettiol S, Wang K, Thompson MJ, Roberts NW, Perera R, Heneghan CJ, Harnden A
Published Online: 
16 May 2012

Whooping cough, or pertussis, is an infectious bacterial disease. It affects infants and small children and can be life-threatening in unimmunised infants younger than three months of age. Infants with whooping cough experience severe bouts of coughing and vomiting which can lead to dehydration and difficulty breathing. Routine vaccination can prevent illness and protect infants and children against death and admission to hospital.

Whooping cough also affects older children and adults and new vaccine strategies are being developed to improve coverage, as neither immunisation nor natural infection result in lifelong immunity. New improved laboratory methods and higher awareness amongst doctors have helped improve surveillance of community outbreaks. These methods have also helped improve diagnosis as antibiotics can limit the course of the disease if given in the early stage of the illness. In the later stages, antibiotics have little individual benefit and treatment with corticosteroids, salbutamol, pertussis specific immunoglobulin (antibodies to increase the body's resistance) or antihistamines has been used in an attempt to reduce the cough while the disease runs its course.

We reviewed 10 studies involving children and adults with whooping cough. Only six of these studies, which included a total of 196 patients, reported their results in enough detail for us to assess them. The studies involved different types of interventions (excluding antibiotics and vaccines) and found that no trial provided enough evidence to determine whether the drugs used can reduce the cough in whooping cough. The risk of side effects was similar in patients treated with pertussis-specific immunoglobulin or placebo.