How Is Whooping Cough (Pertussis) Treated?

Whooping cough, medically known as pertussis, is a potentially serious infection caused by Bordetella pertussis bacteria. The highly contagious infection causes coughing fits, after which some people might make a whooping sound as they breathe in.

A pediatrician or primary healthcare provider can diagnose and treat whooping cough. The main goal of treatment is to clear the infection. Typically, this is done through antibiotics. Frequently, infants need to be hospitalized to help them overcome a whooping cough infection.

Most people eventually fully recover from whooping cough. Even though antibiotics will clear the original infection, symptoms may last for several more weeks. Coughing fits may return after treatment, especially with other respiratory infections. Thankfully, there are steps you can take to minimize its impact.

Medications

The primary treatment for whooping cough is antibiotics. These medications fight the bacteria causing the infection.

It is important to start antibiotics as soon as you are diagnosed with whooping cough. The earlier you begin taking antibiotics, the faster your symptoms may improve and the less severe they may be. You will also be less likely to pass the infection to someone else.

If you start antibiotics three weeks into the illness, the medication won't be effective in treating whooping cough. By this point, the bacteria would already be gone from the body, so the antibiotics wouldn't have anything to fight. Even though the bacteria are gone, the lack of previous antibiotic treatment can make you more susceptible to airway damage that takes longer to heal.

The antibiotics most commonly prescribed for whooping cough are macrolide antibiotics, including:

• Erythromycin (sold under brand names like Erythrocin and ERY-C)
• Azithromycin (sold under brand names like Zithromax and Zmax)
• Clarithromycin (sold under the brand name Biaxin)

Depending on the antibiotic your healthcare provider prescribes, you might have to take the drug for 2-5 days.

Like all medications, macrolide antibiotics can cause side effects. Specific side effects vary depending on the drug, but common side effects include:

• Diarrhea
• Nausea and vomiting
• Stomach pain
• Heartburn
• Gas
• Loss of appetite
• Change in the way things taste
• Headache

Take your prescribed antibiotic exactly as your healthcare provider instructs. For example, you may need to take the medication at a certain time of day or shake it up before you take it. You should also always take the full course of your antibiotic, even if you start to feel better before you finish it.

Macrolide antibiotics are not safe for infants under 4 weeks old. Instead, healthcare providers sometimes give critically ill infants corticosteroids to help them heal.

Isolation

Because whooping cough is extremely contagious, you should isolate as soon as you are diagnosed with it. You can transmit the infection for about two weeks after coughing begins. 

Once you begin taking antibiotics, you should keep isolating for at least five more days. All of your close contacts, including everyone in your household, should begin taking an antibiotic as soon as possible to prevent them from becoming infected.

Supportive Care

The symptoms of whooping cough will slowly go away over the course of several weeks. To help your body heal, you can do the following at home:

• Get lots of rest to help your body recover
• Drink plenty of fluids to prevent dehydration
• Eat small meals often instead of three large meals to help prevent nausea and vomiting
• Eliminate coughing triggers from your home, including smoke, dust, and harmful fumes
• Try using a humidifier to help lessen cough symptoms
• Do not use over-the-counter (OTC) cough medicine unless your healthcare provider says it's okay

Hospitalization

In severe cases of whooping cough, hospitalization may be necessary. This is often the case for infants. At least a third of children younger than 12 months old must be admitted to the hospital for whooping cough. Some experts recommend admitting all children under this age because of the high risk of life-threatening complications. Newborns should be taken to intensive care right away.

In the hospital, treatment typically centers around enabling the person to breathe well, often by keeping the airways clear and giving supplemental oxygen. Medical staff also may provide fluids through a vein (intravenous) to prevent dehydration.

Living With and Managing Whooping Cough

Most people with whooping cough will make a full recovery. However, whooping cough can lead to several complications, especially in children who did not receive their diphtheria, tetanus, and pertussis (DTaP) vaccine and infants under 2 months whose birthing parent didn't receive a tetanus, diphtheria, and pertussis (Tdap) vaccine during pregnancy.

Infants less than 12 months old who have not received any or all of their DTaP vaccines have the highest risk of severe disease and death from whooping cough. While less severe, complications are also possible in adolescents and adults.

The most common complications among infants are apnea (pauses in breathing) and pneumonia (lung infection). About 33-50% of infants with whooping cough are hospitalized. The younger the child, the more likely they are to need hospitalization.

Of the babies who are treated at the hospital, about 20% will get pneumonia, and 1% will die. When death does occur, it is usually in babies younger than 3 months old.

Vaccines and Other Protection Tips

Fortunately, whooping cough cases and deaths are significantly lower than before vaccination became available. Vaccination can help prevent whooping cough in the first place and make the symptoms less severe if you do get whooping cough.

The Centers for Disease Control and Prevention (CDC) recommends that all children receive the DTaP vaccine five times by age 6. Then, adolescents and pregnant people should get a Tdap vaccine. People older than 7 years old who have never had a DTaP shot should also get a Tdap vaccine.

If you have whooping cough, you can help prevent its spread by covering your mouth when you sneeze or cough and washing your hands often. You should also stay home and isolate from others until your healthcare professional tells you it is safe to be around others.

A Quick Review

Whooping cough (pertussis) is a highly contagious bacterial infection that spreads primarily through respiratory droplets. Its first symptoms resemble a common cold but can progress to severe coughing fits.

Antibiotics called macrolides are the main treatment, but infants often must be hospitalized for treatment. Avoiding contact with others and implementing supportive care practices like rest and hydration can also help with treatment.

Seek medical care if you have extreme coughing fits or your child has trouble breathing. Starting whooping cough treatment early can help prevent serious complications and reduce the severity of symptoms.