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Primary Agents
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Primary Agent
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Age Group>
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Azithromycin
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Alternate agent
Erythromycin
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Clarithromycin
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TMP-SMZ
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< 1 month
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Recommended agent. 10mg/kg per day in a single dose for 5 days (only limited safety data available)
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Not preferred. Erythromycin is associated with infantile hypertropic pyloric stenosis. Use if azithromycin is unavailable; 40-50 mg/kg per day in 4 divided doses for 14 days
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Not recommended (safety date unavailable)
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Contraindicated for infants aged < 2months (risk for kernicterus)
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1-5 months
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10 mg/kg per day in a single dose for 5 days
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40-50 mg/kg per day in 4 divided doses for 14 days
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15 mg/kg per day in 2 divided doses for 7 days
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Contraindicated at aged < 2 months. For infants aged ≥ 2 months, TMP 8 mg/kg per day, SMZ 40 mg/kg per day in 2 divided doses for 14 days
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Infants (aged ≥ 6 months) and children
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10 mg/kg in a single dose on day 1 then 5 mg/kg per day (maximum: 500 mg) on days 2-5
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40-50 mg/kg per day (maximum: 2 g per day) in 4 divided doses for 14 days
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15 mg/kg per day in 2 divided doses (maximum: 1 g per day) for 7 days
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TMP 8 mg/kg per day, SMZ 40mg/kg per day in 2 divided doses for 14 days
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Adults
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500 mg in a single dose on day 1 then 250 mg per day on days 2-5
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2 g per day in 4 divided doses for 14 days
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1g per dy in 2 divided doses for 7 days
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TMP 320 mg per day, SMZ 1,600 mg per day in 2 divided doses for 14 days
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Trimethroprim sulfamethoxazole (TMP-SMZ) can be used as an alternative agent to macrolides in patients aged >2 months who are allergic to macrolides, who cannot tolerate macrolides, or who are infected with a rare macrolide-resistant strain of Bordetella pertussis. Table is from MMWR, December 9, 2005, Vol54/No. RR 14, Recommended Antimicrobial Agents for Treatment and Postexposure Prophylaxis of Pertussis.
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