Prophylactic use of antibiotics and reduced case fatality in measles infection.

Measles is currently responsible for 1.4 million deaths per year.' Virtually all of these deaths occur in developing countries and are related to complications of the disease. Little is known about measles complication rates in the general population in developing countiies. However, hospital studies have shown that pneumonia, diarrhea and laryngitis are very common in severe and fatal cases of A considerable part of these complications is of bacterial origin. Hence an effective antibiotic prophylaxis against bacterial infections could potentially prevent a large number of measles-related deaths. Use of antibiotics in the absence of bacterial infections may cause many problems, including pneumonia caused by nosocomial infections3 and increased antibiotic resistance. Nonetheless our recent experience with prophylactic antibiotics for measles cases in Senegal suggests that such use may be beneficial and that further studies are needed.