C T Naugler1, S A Halperin. 1. Departments of Pediatrics, Microbiology and Immunology, Dalhousie University, Halifax, Nova Scotia.
Abstract
OBJECTIVE: To document initial investigations and treatment used in the management of children hospitalized with pertussis. DESIGN: Retrospective chart review encompassing admissions from January 1, 1991 to June 1, 1995. SETTING: Six Canadian pediatric hospitals representing about 39% of the pediatric tertiary care beds in Canada. PATIENTS: Four hundred and forty children who met the inclusion criterion of a primary admitting diagnosis of pertussis and who did not meet the exclusion criterion of nosocomially acquired pertussis or a prior admission for pertussis during the study period. MAIN RESULTS: Most patients had cultures positive for Bordetella pertussis, although the proportion of positive tests varied widely among hospitals. Erythromycin was the most commonly used medication; however, only 47% of children received the recommended dosage. Salbutamol and corticosteroids were used most often in patients with reactive airways disease. Younger children and those with reactive airways disease had longer lengths of stay in hospital. CONCLUSIONS: Pertussis treatment varied widely among the six hospitals studied, and was often not consistent with current Canadian recommendations. The results will allow practitioners to place their practices in a national perspective and provide a baseline for further studies.
OBJECTIVE: To document initial investigations and treatment used in the management of children hospitalized with pertussis. DESIGN: Retrospective chart review encompassing admissions from January 1, 1991 to June 1, 1995. SETTING: Six Canadian pediatric hospitals representing about 39% of the pediatric tertiary care beds in Canada. PATIENTS: Four hundred and forty children who met the inclusion criterion of a primary admitting diagnosis of pertussis and who did not meet the exclusion criterion of nosocomially acquired pertussis or a prior admission for pertussis during the study period. MAIN RESULTS: Most patients had cultures positive for Bordetella pertussis, although the proportion of positive tests varied widely among hospitals. Erythromycin was the most commonly used medication; however, only 47% of children received the recommended dosage. Salbutamol and corticosteroids were used most often in patients with reactive airways disease. Younger children and those with reactive airways disease had longer lengths of stay in hospital. CONCLUSIONS: Pertussis treatment varied widely among the six hospitals studied, and was often not consistent with current Canadian recommendations. The results will allow practitioners to place their practices in a national perspective and provide a baseline for further studies.