SUMMARY:We conducted a retrospective study in 57 children (median age, 3.5 years; range, 1 month-14.5 years) with microbiologically confirmed pertussis infection over a recent 4-year period in a regional hospital in Japan. We obtained nasal swabs from all patients for Bordetella pertussis isolation as well as performed B. pertussis DNA detection using loop-mediated isothermal amplification (LAMP). Of the 57 cases, 34 (60z) were culture-positive and 57 (100z) were LAMP-positive. The frequency of each symptom was as follows: typical paroxysmal cough for over 14 days, 96z (55/57); paroxysms, 86z (49/57); posttussive vomiting, 33z (19/57); inspiratory whoop, 25z (14/57); and apnea, 12z (7/57). Hospitalization was required in 14 cases (25z), 93z (13/14) of which were aged º1 year. The proportion of patients previously immunized against diphtheria-tetanus-acellular pertussis vaccine (DTaP) was 19z (4/21) in children aged º 1 year and 92z (11/12) in children aged AE 10 years. Minimum inhibitory concentrations for 6 antimicrobials (erythromycin, clarithromycin, azithromycin, minocycline, amoxicillin, and sulfamethoxazole/trimethoprim) were measured for 30 isolated strains, and all strains were susceptible to all aforementioned antimicrobials. Thus, an additional pertussis vaccination in older children is necessary, and the current macrolides-based treatment strategy is considered reasonable.