three dimensional model of Azithromycin
Model of the antibiotic Azithromycin molecule

Antibiotics in whooping cough

What is the role of antibiotics

Antibiotics do not cure it or get you better faster unless taken in the incubation period or soon after.

Antibiotics are used to kill the bacteria that cause whooping cough. Although most authorities say there is no need for this after 3 weeks, some people keep coughing out live bacteria for up to 6 weeks from the start of symptoms. Because knowing when to start counting the start from is also difficult, it may be a better strategy to give an antibiotic up to perhaps 5 weeks where quarantine is not practicable.

Erythromycin (macrilide family of antibiotics) is mostly used. A related antibiotic, Azithromycin (image of 3D model above), is most popular because it is better tolerated and a shorter course. Co-trimoxazole is an alternative. 

After 3 days on an antibiotic the bacteria are believed to be  dead and you cannot pass it on.

Some people get a secondary infection on top of pertussis, causing bronchitis with infected sputum and a productive cough. Sometimes even pneumonia. These may require antibiotics appropriate to whatever the infection is likely to respond to.

If erythromycin is taken in the incubation period it can stop it developing.

If erythromycin is taken when the symptoms are just starting it MAY shorten the illness.

Bordetella pertussis is NOT sensitive to amoxicillin.

Details of antibiotic dosages for pertussis 

Taken from Public Health England’s ‘Pertussis brief for medical professionals‘ 2018


This page has been reviewed and updated by Dr Douglas Jenkinson 23 September 2019

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