Lecture 18 Flashcards
what is pertussis, how does it sprad
whooping cough
bacteria remain on surface of airways
spread by cough and nasal droplets
how does bacteria work in pertrusis
bacteria produces toxins, which paralyze respiratory cell cillia. doesnt allow body to clear out mucous
pertussis common pathogen
bordetella perussis
aerobic gram - coccobacillus
humans are the only host
which age group is most susceptible
infants
first stage of pertussis
catarrhal stage, lasts 1-2 weeks.
runny nose, sneezing, low grade fever, mild cough
second stage of pertussis
paroxysmal stage (lasts 1-6 weeks)
bursts of cough, thick music, high pitched whoop
can vomit and get exhausted
appear normal between attacks
last stage
Convalescent stage, gradual recovery
what happens if you have ab in the cat stage
may prevent or minimize severity
what happens if you have ab in the paroxysmal stage
decreases transmission to others but does not affect duration of pertussis or severity of disease
Which class of ab do we give
macrolides, if allergy, then tmp smx
dose of macrolides - clarithromycin
7.5mg/kg PO BID x 7 days
dose of macrolides - azithromycin
10mg/kg PO daily x 5 days
dose of macrolides - erythromycin
10mg/kg PO QID x 7 days
if macrolide allergy, dose of TMP/SMX
4mg/kg PO BID x 10 days
does diphenhydramine work
no
does salbutamol work
no change in coughing
how effective it pertussis immunization
85%, but need boosters
who do we give antibiotics to as prevention
- infants under 2 months of age
- infants under 12 mo age if unvaccinated
- pregnant woman in 3rd trimester
- direct contacts prior to them developing signs/symptoms
what is defined as direct contact
- face to face exposure for less than 5 minutes
- shared confined space in close proximity for greater than an hour
- respiratory, oral, or nasal secretion –> kissing, coughing, sneezed upon
pertussis prevention dose azithromycin
Infant < 6 mo: 10mg/kg PO daily for 5 days
Child: 10mg/kg PO x 1 then 5mg/kg PO daily x 4 days
Adults: 500mg PO x 1 then 250mg PO daily x 4 days
pertussis prevention dose clarithromycin
child: 7.5mg/kg PO BID x 7 days
adults: 500mg PO BID x 7 days
which med to use in pregnant woman
azithro or erythro
allergy to macrolides, tmp/smx dosing prevention
child: 4mg/kg PO BID x 10 days
adult: 1DS tab PO BID x 10 days
Croup risk factors
- late fall- early winter disease
- age: 3 mo - 3 years of age
- boys > girls
