From the Guidelines
If you've had close contact with someone who tested positive for pertussis (whooping cough), you should take preventive antibiotics, known as post-exposure prophylaxis, even if you don't have symptoms, to reduce the risk of infection and transmission. The recommended antibiotic is azithromycin, typically prescribed as 500mg on day 1, followed by 250mg daily for days 2-5, as stated in the 2005 CDC guidelines 1. Alternatives include clarithromycin (500mg twice daily for 7 days) or trimethoprim-sulfamethoxazole (one double-strength tablet twice daily for 14 days).
Key Considerations
- Contact your healthcare provider immediately to get a prescription, especially if you have been in close contact with someone who has pertussis, as defined by face-to-face contact, sharing a confined space, or direct contact with respiratory secretions 1.
- While waiting for antibiotics, limit contact with others, especially infants, pregnant women, and those with weakened immune systems, to prevent potential transmission.
- Monitor yourself for symptoms like runny nose, mild cough, or low-grade fever for 21 days after exposure, and seek medical attention if symptoms develop.
Prevention and Transmission
- Pertussis is highly contagious and spreads through respiratory droplets, making preventive measures crucial to reduce transmission risk.
- Antibiotics help prevent infection and reduce transmission risk by eliminating the bacteria from your respiratory tract before it causes disease or spreads to others, as recommended by the CDC guidelines 1.
From the FDA Drug Label
Erythromycin is effective in eliminating the organism from the nasopharynx of infected individuals, rendering them noninfectious Some clinical studies suggest that erythromycin may be helpful in the prophylaxis of pertussis in exposed susceptible individuals.
The recommended approach for close contact with a person who tested positive for Pertussis (Whooping Cough) is to consider prophylaxis with erythromycin for exposed susceptible individuals to prevent the development of the disease. This is based on the fact that erythromycin can eliminate the organism from the nasopharynx of infected individuals, rendering them noninfectious 2. Key points to consider include:
- Erythromycin may be helpful in preventing pertussis in exposed susceptible individuals
- The goal of prophylaxis is to prevent the development of the disease in close contacts.
From the Research
Recommendations for Close Contact with a Person who Tested Positive for Pertussis
- Post-exposure prophylaxis (PEP) is recommended for household contacts of pertussis cases within 21 days of exposure 3
- Antibiotics such as azithromycin, clarithromycin, or erythromycin can be used for PEP and treatment of pertussis 4, 5, 6
- Azithromycin is associated with higher completion rates and fewer side effects compared to erythromycin 5
- Short-term treatment with clarithromycin or azithromycin is expected to be equal or superior to the standard long-term erythromycin regimen for pertussis 6
- Daily symptom monitoring without PEP may not be sufficient to prevent pertussis infection in vaccinated healthcare personnel, and antibiotic PEP may be necessary 7
Antibiotic Regimens
- Azithromycin for 3-5 days 4, 5, 6
- Clarithromycin for 7 days 4, 6
- Erythromycin for 14 days 4, 6
- Trimethoprim/sulfamethoxazole for 7 days may be an alternative antibiotic treatment for patients who cannot tolerate a macrolide 4