Notes

1. Consider diagnosis in afebrile patients, including adults, with persistent cough.

2. Treatment of household contacts recommended.

3. Differential diagnoses include gastroesophageal reflux, asthma, and postnasal drip.

A. PEDIATRIC

1. Erythromycin estolate (Ilosone) 40 mg/kg/day PO divided bid-tid for 7 days [contraindicated in pregnancy] Easy dose: 20 mg/kg/dose PO bid for 7 days

Maximum: 250-500 mg per dose Liquids: 125 mg and 250 mg/5 cc

2. Erythromycin ethyl succinate (EES) 30-50 mg/kg/day PO divided qid for 14 days [B] Easy dose: 10 mg/kg/dose PO qid for 14 days

Maximum: 250-500 mg per dose Liquids: 200 mg and 400 mg/5 cc

3. TMP/SMX (Bactrim, Septra) 10 mg/kg/day TMP & 50 mg/kg/day SMX PO divided bid for 14 days [C; D in 3rd trimester] Easy dose: 1.25 cc/kg/day PO divided bid for 14 days

Maximum: 20 cc per dose

Suspension of TMP 40 mg and SMX 200 mg/5 cc

B. ADULTS

1. Erythromycin estolate (Ilosone) 500 mg PO qid for 7 days [contradicted in pregnancy]

2. TMP/SMX DS (Bactrim DS, Septra DS) 1 tablet PO bid for 14 days [B; D in 3rd trimester]

Organisms: Bordetellal pertussis, Bordetella parapertussis Pneumonia

(Note two drug therapy) Ceftriaxone is no longer recommended in neonates because of the potential for biliary sludge pseudolithiasis.

2. Nafcillin 50 mg/kg IV q6h [B] OR (if suspect MRSA)

3. Vancomycin (Vancocin) 10 mg/kg IV q6h (max 1 g; monitor serum levels) [C] PLUS

1. Gentamicin (Garamycin) 2 mg/kg IV loading dose, then 1.7 mg/kg IV q8h (monitor serum levels) [D] OR

2. Cefotaxime (Claforan) 50 mg/kg IV q6h [B]

Organisms: group B Strep, Listeria, coliforms, Staph. aureus, Pseudomonas, Chlamydia

B. PEDIATRIC (1 MONTH-18 YEARS)

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