Drug-resistantBordetella pertussis
What you need to know
Bordetella pertussis bacteria cause pertussis (whooping cough), a highly contagious respiratory disease. Pertussis can cause serious disease, complications, and deaths, especially in young infants and children. The best way to prevent serious complications from pertussis is to get vaccinated.
What we know about resistance
Macrolides are the class of antibiotics recommended to treat pertussis, and include azithromycin, clarithromycin, and erythromycin. Although macrolide-resistant Bordetella pertussis (MRBP) was first reported in the United States in 1994, few cases have since been reported. During 2024 and 2025, two MRBP cases were identified in the United States, the first since 2018. There has also been an increase in global detection of MRBP, with new or increasing cases reported in Australia, Finland, France, Mexico, Brazil, Japan, and Peru since 2024, in addition to continuing high rates of MRBP in China.
If macrolide resistance becomes more common in the United States, it may lead to additional severe infections or deaths, especially among infants. Increased resistance may also complicate attempts to stop spread, including the use of prophylaxis (when people receive antibiotics after being exposed to pertussis).
What CDC is doing
CDC closely monitors drug resistance in the United States by testing isolates (pure samples of Bordetella pertussis) through CDC's Enhanced Pertussis Surveillance program. CDC also engages with healthcare providers on pertussis prevention strategies and coordinates with global partners to track MRBP around the world and prevent spread to the United States.