# Therapeutic Role of Hydroxyurea in Paediatric Hydroxyurea Pertussis: A systematic review

## TL;DR

Hydroxyurea may help reduce white blood cells in severe whooping cough in children, but more research is needed to confirm its safety and effectiveness.

## Contribution

This review explores hydroxyurea as a potential treatment for leukoreduction in pediatric pertussis.

## Key findings

- Hydroxyurea was associated with leukocyte reduction in reported cases.
- It may reduce the need for invasive procedures in resource-limited settings.
- Evidence is limited to case reports with no long-term follow-up.

## Abstract

This systematic review indicates that hydroxyurea may be a promising pharmacologic option for leukoreduction in paediatric critical pertussis. In reported cases, hydroxyurea was associated with leukocyte reduction and short-term survival. Its ability to potentially reduce the need for invasive leukoreductive procedures is especially relevant in resource-limited settings. While these observations are encouraging, the evidence base remains limited to a small number of uncontrolled case reports and case series, with inconsistent safety monitoring and no long-term follow-up. Given the very low certainty of the available evidence, these results should be considered preliminary and hypothesis-generating. Further well-designed, multicentre studies and randomised trials are urgently needed to confirm whether hydroxyurea can fulfil its potential as an effective and safe adjunctive treatment for this high-risk population.