Objective  To investigate the clinical efficacy of combined therapy with bifidobacterium triple viable bacteria and azithromycin in children with pertussis.

Methods  Clinical data of children with pertussis treated at the Department of Pediatrics, Jiaxing Maternal and Child Health Hospital from July 2022 to September 2024 were retrospectively analyzed. Patients were divided into the conventional treatment group (azithromycin alone) and the combination treatment group (azithromycin combined with bifidobacterium triple viable bacteria). Observation indicators included clinical efficacy, serum inflammatory factors (IL-10, CRP and TNF-α), immune function levels (CD3⁺ T cells, CD4⁺ T cells, CD8⁺ T cells, and CD4⁺/CD8⁺ T cells ratio), and adverse reactions.

Results  A total of 103 patients were included in the study, with 48 in the conventional treatment group and 55 in the combination treatment group. After 14 d of treatment, there was no statistically significant difference in total effective rate between the two groups (P>0.05). Compared with the conventional treatment group, the serum IL-10, TNF-α, CRP and CD8⁺ cell levels of the combination treatment group were significantly lower than those of the conventional treatment group (P<0.05); the CD3⁺ T, CD4⁺ T cell levels and CD4⁺/CD8⁺ T cell ratio were significantly higher than those of the conventional treatment group (P<0.05). There was no significant difference in the occurrence of adverse reactions between the two groups (P>0.05).

Conclusion  The combined application of bifidobacterium triple viable bacteria does not affect the clinical efficacy and safety of azithromycin in treating pediatric pertussis, and exerts a synergistic therapeutic effect through regulating immune inflammatory responses.

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