COMPARISON OF THE THERAPEUTIC EFFICACY OF FOUR AGENTS IN PERTUSSIS

Abstract

The results of the study suggest that H. pertussis infection is usually a mild disease in all age groups if there is effective control of most secondary bacterial infections by penicillin. Not one of the four therapeutic agents studied, streptomycin, chloramphenicol, antipertussis rabbit serum and hyperimmune human serum, was shown to bring about prompt elimination of the signs of pertussis. On the basis of duration of the infection in the patients studied, however, only 30% were suitable clinical material for comparing therapeutic agents in pertussis. The hypothesis is advanced that prompt recovery from pertussis can be anticipated only when effective therapy is instituted early in the course of the disease; the preparoxysmal stage is recommended. While the data failed to show convincing therapeutic value of any of the four specific agents tested, they suggested some modification by each. A significant difference in degree of influence among the four treatments was not demonstrated. On the basis of toxicity, case of administration and cost, chloramphenicol is for the present the agent of choice. In a comparison of the capacity of the four treatments to eliminate H. pertussis from the nasopharynx, rabbit antiserum was best and chloramphenicol next. All four specific therapeutic agents showed some influence on the characteristic response in the white blood cell count.