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Will Azithromycin Be Effective For Pertussis Treatment When Suffering From Bronchitis?

Posted on Wed, 22 Jan 2014

Question: Hi have had cough for 3 wks comes in fits rarely feel like im going to pass out. No fevers but fatigue. No significant sputum.had ct of chest showed one lobule involvement in left lower lobe with tree in bud appearance. Originally put on ceftin then doxy no change. Developed expiratory wheezing and some high pitched sounds after coughing. Xopenex mdi relieved wheezes in 3 days. My pcp thought azithromycin as he thought i may have pertussis. Awaiting results of culture and pcr. Problem was i was on multaq for parox afib i get one bout per year. Only took it for 8 days been off of it for 7 days. Question since ct showed bronchiolitis for sure and questionable interstitial pneumonia will azithromycin be effective for treatment of the pertussis if in fact this bug is the source of my problem? And since ive had symptoms for 3 weeks will the antibiotic be helpful in treating the infection? Thx

Answered by Dr. Gyanshankar Mishra (1 hour later)

Brief Answer: Antibiotic needs to be as per culture report. Detailed Answer: Hi, Thanks for posting the query on XXXXXXX After going through your query, I would like to comment the following: 1. You seem to be suffering from infective bronchiolotis. 2. A 3 weeks course of antibiotics, inhaled and oral bronchodilators should provide relief. 3. A bronchoscopy may help and Bronchial washings may be required to be sent for evaluation including culture sensitivity. 4. Blood investigations including complete counts and differential counts will be required and so will be a PFT. 5. Its better to titrate the antibiotic as per culture sensitivity report and till then a broad spectrum antibiotic may help. 6. Taking antibiotic on and off with gaps in between is not recommended, rather a continuous 3 week course of antibiotic which is titrated as per reports, is recommended. Clarithromycin or amoxicillin clavulinc acid should be a reasonable choice but the final choice depends with your pulmonologist. I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gyanshankar Mishra (2 days later)

Now on avelox feel better knife like pain though under rib cage sore to touch hurts worse when coughing pft showed mod restrictive pattern also heart rate in low 60's usually in high 40s off corticosteroids and havent used xopenex in 24 hrs not sure what to do thx

Answered by Dr. Gyanshankar Mishra (12 hours later)

Brief Answer: Continue avelox full course. Detailed Answer: Hi, Thanks for the follow up. After going through the query, I would like to comment the following: 1. Continue avelox and you can take xopenox twice a day for 14 days. 2. If chest pain is there, an analgesic can be taken for symptomatic relief. 3. After 2 weeks, reassessment can be done and a xray chest can be repeated. I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologis

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Gyanshankar Mishra (2 hours later)

Influenza a and b screen came back negative. Sent another for h1 n1 . Also repeat ctscan showed mild worsening of same pattern if this is h1n1 pneumonia and ive had symptoms for close to 4 wks will this progress to resp failure or do i have a better chance of resolution. Thx

Answered by Dr. Gyanshankar Mishra (2 hours later)

Brief Answer: Empirical treatment can be started. Detailed Answer: Hi, Thanks for the follow up. After going through the query, I would like to comment the following: 1. If there is a suspicion of viral pneumonia, then empirical oseltamavir can be given for 5 days. In absence of any cold symptoms, H1N1 seems to be less likely. 2. An addition of antibiotic for atypical coverage can help. 3. At present it is difficult to predict the course but worsening after 4 weeks of symptoms seems less likely. 4. Just check if your physician is planning a bronchoscopy. I hope I have answered your query. I will be glad to answer follow up queries if any. Please accept my answer if you have no follow up queries. Regards Dr. Gyanshankar Mishra MBBS MD DNB Consultant Pulmonologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar