We report two cases of pertussis in patients with bronchial asthma, in spite of a history of DPT (Diphtheria Pertussis Tetanus) immunization. In bronchial asthma, severe cough may be due to pertussis, despite DPT immunization. Thus, physicians should consider the possibility of pertussis in bronchial asthma even when there is a history of DPT immunization, and it is important to give them antibiotics (Azithromycin, Clarithromycin, Erythromycin etc) which may be effective for pertussis.

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The optimal dose of a sustained-release theophylline preparation (Theodur dry syrup^®) was investigated. Theodur dry syrup^® was administered orally for at least one week to 150 children with bronchial asthma in ages ranging from six months to twelve years (median: 4.5 years), and serum concentrations of theophylline were measured between 3 and 5 hours after dosing. The results showed that, in children between six and eleven months of age, serum levels of theophylline were above 10μg/ml in some cases, even when the daily dose was less than 8mg/kg, and thus, the initial daily dose for children in this age group should be slightly lower. In one-year-old children, the serum concentration of theophylline did not exceed the target range of 5-10μg/ml in any patients when the daily dose was less than 11mg/kg. Therefore, the recommended initial daily dose of 8-10mg/kg to children in this age group seems appropriate. In children two years of age and older, the results suggest that it is necessary to start administration at a daily dose of 10mg/kg and then to increase the dose while monitoring theophylline concentration in the serum. The C/D ratio (serum concentration/dose) for children younger than one year of age was higher than that for children in the other age groups, and the degree of interindividual variations was also greater. Taken together, these findings suggest that it will be necessary to stratify the administration of sustained-release theophylline for different age groups.

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[in Japanese]

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