ORIGINAL RESEARCH article
Front. Pediatr.
Sec. Pediatric Infectious Diseases
Compound Sulfamethoxazole for Pediatric Pertussis: A Retrospective Cohort Study in a Region with High Macrolide Resistance
Provisionally accepted
- ziyang people's hospital, Ziyang, Sichuan, China
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Background In recent years, the incidence of pertussis has been increasing globally. The high prevalence of macrolide-resistant strains has led to a significant rise in both pertussis cases and associated mortality. Objective This retrospective study aimed to evaluate the clinical effectiveness and safety of compound sulfamethoxazole (SMZco) versus macrolides in pediatric pertussis treatment under real-world clinical conditions, providing evidence for its clinical application. Methods Patients were divided into macrolide and SMZco groups based on treatment regimens. Comparative analyses included overall treatment effectiveness, duration of nocturnal coughing, paroxysmal coughing, post-tussive vomiting, hospitalization length, and adverse drug reactions. Results The macrolide group (n=23) showed 3 markedly effective, 8 effective, and 12 ineffective cases (total effectiveness rate 47.8%). The SMZco group (n=79) demonstrated 26 markedly effective, 38 effective, and 15 ineffective cases (total effectiveness rate 81.0%), with significantly superior effectiveness versus macrolides (P<0.05). The SMZco group exhibited statistically significant reductions in hospitalization duration (P<0.05), paroxysmal coughing (P<0.05), posttussive vomiting (P<0.05), and nocturnal coughing (P<0.05). Gastrointestinal adverse events occurred in 8 macrolide-treated patients versus 6 SMZco-treated patients (P<0.05). Rash was observed in 12 SMZco-treated cases but none in the macrolide group (P<0.05). Conclusion SMZco significantly improves treatment effectiveness, shortens symptom duration and hospitalization, and reduces economic burden in pediatric pertussis. These findings position SMZco as an effective and safe alternative, particularly in regions with high macrolide resistance.
Keywords: Whooping Cough, Child, Therapeutics, compound sulfamethoxazole, macrolide resistance
Received: 03 May 2025; Accepted: 19 Nov 2025.
Copyright: © 2025 Li, Xie, Xiao, Zhong, Wang and Su. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Taohong Xie, 1582100261@qq.com
Mingying Wang, 191136380@qq.com
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