[Pertussis chemoprophylaxis: a sterile effort?].
Pertussis chemoprophylaxis is indicated for contacts at risk of death or of severe complications if infected with Bordetella pertussis; e.g. neonates and infants <or= 12 months of age, elderly individuals, individuals with cardiac and/or respiratory insufficiency, and pregnant women during their third trimester of pregnancy (in order to protect their offspring). Available evidence indicates that PChP is effective and thus recommendable for high risk household contacts within a 21 day window after the beginning of symptoms of the index case, and if no secondary case has occurred, recommendation that may be extended to high risk individuals that co-habit with an index case at hospital, daycare centers or institutionalized elderly people. Bordetella pertussis can be transmitted by respiratory droplets that can travel further than the critical distance of 1.5 meters. This long distance transmissibility is relevant when considering who should receive prophylaxis during a nosocomial outbreak. Current evidence supports the use of macrolides and azalides for Pertussis chemoprophylaxis; seven days of erythromycin or clarithromycin and five days of azythromycin are sufficient to eradicate B. pertussis.
Cofré Guerra
José
J
Unidad de Infectología, Hospital Luis Calvo Mackenna. pepecofre@123.cl
D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D017963:Azithromycin / Q000008:administration & dosage; D017291:Clarithromycin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D004917:Erythromycin / Q000008:administration & dosage; D006801:Humans; D012307:Risk Factors; D012720:Severity of Illness Index; D014917:Whooping Cough / Q000517:prevention & control* / Q000635:transmission
D000900:Anti-Bacterial Agents; D004917:Erythromycin; D017963:Azithromycin; D017291:Clarithromycin