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Pertussis
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Counseling
Antibiotics help prevent spreading pertussis to others but may not shorten the cough, which can last weeks to months. Keep the child away from young infants and pregnant people until 5 days of antibiotics are done. Recommended supportive care with an emphasis on hydration, small frequent meals, and rest. Call 911 for pauses in breathing or blue color. Return precautions given including trouble breathing, poor feeding, vomiting after coughing that keeps the child from keeping fluids down, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
CounselingNot in the note with these choices
The cough of pertussis can last weeks to months, and antibiotics are no longer helpful this late in the illness. Recommended supportive care with an emphasis on hydration, small frequent meals, and rest. Call 911 for pauses in breathing or blue color. Return precautions given including trouble breathing, poor feeding, new symptoms, prolonged symptoms, worsening symptoms, and other concerns. Caregiver expressed understanding and agreement with plan. Answered all questions.
What the sources cover
- PCR within 3 weeks of cough
- Clinical diagnosis (paroxysms, whoop, emesis)
- No apnea, cyanosis, feeding difficulty
- Infants < 6 months most severe
- Azithromycin first line; treat before results if suggestive or high risk
- TMP-SMX alternative over 2 months
- After paroxysms established, antibiotics limit spread only
- Hospitalization factors
- Exclusion until 5 days of antibiotics, or 21 days from cough onset untreated
- PEP for household and close contacts; monitor 21 days
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- Immunize under-immunized contacts