PERTUSSIS SUMMARY OF PEP POST EXPOSURE PROPHYLAXIS (PEP)
Post-exposure chemoprophylaxis (PEP) <ul><li>People with the highest priority for PEP include:  </li></ul><ul><li>1) close...
Post-exposure chemoprophylaxis (PEP) INDICATIONS <ul><li>CDC and AAP recommend PEP for all close contacts (of confirmed ca...
Postexposure Prophylaxis  <ul><li>Administration of postexposure prophylaxis to asymptomatic household contacts  within 21...
Tx is the same for  Symptomatic Pertussis & PEP <ul><li>Azithromycin.  Adults: 500 mg on day 1, followed by 250 mg per day...
Close contact definition <ul><li>Those who have had direct contact with respiratory, oral or nasal secretions from a sympt...
High risk   ( for severe pertussis disease  ) Contact Definition <ul><li>Contacts at high risk for severe pertussis diseas...
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Pertussis pep

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Pertussis pep

  1. 1. PERTUSSIS SUMMARY OF PEP POST EXPOSURE PROPHYLAXIS (PEP)
  2. 2. Post-exposure chemoprophylaxis (PEP) <ul><li>People with the highest priority for PEP include: </li></ul><ul><li>1) close contacts in household, childcare, and healthcare settings; </li></ul><ul><li>2) close contacts at high risk for severe disease and adverse outcomes; </li></ul><ul><li>3) close contacts who may transmit disease to persons at high risk for severe disease; </li></ul><ul><li>4) and close contacts in group settings where close interactions occur (e.g., after-school care groups, playgroups, groups of close friends, teammates, etc.). </li></ul>
  3. 3. Post-exposure chemoprophylaxis (PEP) INDICATIONS <ul><li>CDC and AAP recommend PEP for all close contacts (of confirmed cases) , regardless of age or immunization status. </li></ul><ul><li>Starting PEP ≥3 weeks after exposure to an infectious case is probably of no benefit to the contact. </li></ul>
  4. 4. Postexposure Prophylaxis <ul><li>Administration of postexposure prophylaxis to asymptomatic household contacts within 21 days of onset of cough in the index patient ,can prevent symptomatic infection. </li></ul><ul><li>PEP recommended for all household close contacts of confirmed cases </li></ul><ul><li>Coughing (symptomatic) household members of a pertussis patient should be treated as if they have pertussis. </li></ul><ul><li>Low Threshold for PEP in exposure settings that include infants aged <12 months or women in the third trimester of pregnancy </li></ul>
  5. 5. Tx is the same for Symptomatic Pertussis & PEP <ul><li>Azithromycin. Adults: 500 mg on day 1, followed by 250 mg per day on days 2--5. </li></ul><ul><li>Clarithromycin . Adults: 500 mg po bid for 7 days. </li></ul><ul><li>Erythromycin . Erythromycin estolate 500 mg po qid x 14 days </li></ul><ul><li>Alternate agent (TMP--SMZ). Bactrim DS 1tab po bid x 14 days </li></ul>
  6. 6. Close contact definition <ul><li>Those who have had direct contact with respiratory, oral or nasal secretions from a symptomatic case (catarrhal or paroxysmal stages), e.g., a cough or sneeze in the face, sharing food/eating utensils, kissing </li></ul><ul><li>Performing a medical examination of the nose and throat ( without mask / gloves ) </li></ul><ul><li>Sharing a confined space in close proximity for a prolonged period of time (≥1 hour) with a symptomatic case. </li></ul>
  7. 7. High risk ( for severe pertussis disease ) Contact Definition <ul><li>Contacts at high risk for severe pertussis disease and adverse outcomes include: </li></ul><ul><li>1 ) Contacts who may transmit pertussis to a high risk person (healthcare or childcare workers) </li></ul><ul><li>2 ) Pregnant or recently post-partum women </li></ul><ul><li>3 ) Infants <6 months of age, especially premies </li></ul><ul><li>4 ) Unimmunized infants and children </li></ul><ul><li>5 ) Persons with neuromuscular disease </li></ul><ul><li>6 ) Persons who have severe underlying disease such as chronic lung disease or cystic fibrosis or immunocompromised </li></ul>

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