Whooping cough treatment

Young children and all patients with severe and complicated whooping cough are subject to hospitalization. Treatment of whooping cough is mainly pathogenetic and symptomatic.

Treatment of mild to moderate whooping cough

• Antibiotics are effective only at the very beginning of the disease (in the catarrhal period) and in the first days of spasmodic cough. Early use of antibiotics helps to significantly alleviate coughing fits, reduce their number and shorten the duration of the disease. Levomycetin, erythromycin, ampicillin in age-appropriate doses are recommended. The course of treatment is 7-10 days. Antibiotics are ineffective in the spasmodic period.
• To reduce the frequency and severity of attacks of spasmodic cough, neuroleptic drugs (chlorpromazine, propazine) are prescribed, which relieve bronchospasm, reduce the excitability of the respiratory center, help calm the patient and deepen sleep (a 2.5% solution of chlorpromazine is administered parenterally at a rate of 1-3 mg/kg per day with the addition of 3-5 ml of a 0.25% solution of novocaine).
• To combat hypoxia and hypoxemia, oxygen therapy is prescribed, preferably in an oxygen tent. During apnea, it is necessary to suck out mucus from the nose and oropharynx and perform artificial ventilation of the lungs.
• To suppress the allergic component, antihistamines are widely used: diphenhydramine, promethazine, chloropyramine (suprastin), etc. in normal doses. In severe cases, glucocorticoids are used with good effect at the rate of prednisolone 1.5-2 mg/kg per day for 7-10 days.
• Medicines that thin viscous sputum and improve the function of external respiration are widely used. Inhalations of ambroxol aerosols with proteolytic enzymes (trypsin, chymotrypsin) and antispasmodics (euphyllin, ephedrine) are used.

Throughout the illness, the patient is shown fresh cool air, which has a calming effect on the central nervous system and leads to weakening and decreasing attacks of spasmodic cough. It is necessary to exclude external irritants that cause an attack of spasmodic cough, if possible, avoid medical manipulations, examinations of the oropharynx, etc. It is necessary to provide a complete vitamin-rich diet. If the child vomits frequently, it is necessary to feed him additionally. If inflammatory phenomena occur, antibiotics in combination with probiotics (Acipol) are necessarily prescribed.

Treatment of severe whooping cough

• Walks with the child are a must.
• One of the antibiotics is erythromycin, rulid and other macrolides, ampicillin (orally or intramuscularly for a course of up to 7 days).
• In case of pneumonia development - 2 broad-spectrum antibiotics parenterally.
• Children in the first months of life can be placed in an incubator for several days, creating a subtropical climate in it (humidity 80-90%, oxygen concentration 30-40%, temperature up to 30 °C), or an oxygen tent can be used.
• Sedatives: seduxen at a dose of 0.3-0.5 mg/kg 3-4 times a day in combination with pipolfen, aminazine at a dose of up to 1 mg/(kg per day), phenobarbital (3-5 mg/kg per day) orally. Valerian and motherwort extracts can be prescribed orally.
• Lasix at a dose of 0.5-1.0 mg/kg 1-2 times a day for encephalopathy for 2-3 days, then Diacarb - up to 2-5 mg/kg per day every other day.
• Cavinton, Trental and Euphyllin to improve cerebral and pulmonary blood flow, followed by nootropics (piracetam, aminalon, etc.).
• At first, drugs are prescribed that suppress cough (tusuprex, sinekod, libexin, tussin plus), then, when sputum appears, drugs that facilitate its separation (tussamag, bronholitin, pectussin, mucaltin, anise drops, thermopsis); inhalations with saline solution, mineral water.
• Parenteral administration of hydrocortisone at a dose of 5 mg/(kg/day) for 5 days is recommended.
• Chest massage, physiotherapy, breathing exercises.
• ALV is prescribed for prolonged apnea, severe cerebral hypoxia, and convulsive status. Synchronization to the device is achieved using seduxen and GOMC.
• The diet is mechanically gentle, easily digestible; meals are fractional; the child needs to be fed after a coughing fit that ends in vomiting.