Pertussis (Whooping Cough)

• This guideline is for both the treatment and post-exposure prophylaxis of adult patients and adult contacts only.
• Treatment is best started within 2 weeks of onset of symptoms in non-immunocompromised patients and within 4 weeks if immunocompromised.

Pathogen

• Bordetella pertussis (notifiable)

Drug Treatment

azithromycin HMLSchedNZFPML Azithromycin F: 0.4 Half life: 60 hours Elimination: substantial biliary excretion fe: 0.1 Additional points: ↑ warfarin effect.

PO 500 mg stat on day 1 then 250 mg once a day for 4 days

OR

trimethoprim+sulfamethoxazole HMLSchedNZFPMLnoids Trimethoprim+Sulfamethoxazole F: 0.8 Half life: 9 hours / 12 hours Elimination: CYP2C8/9 acetylated fe: 0.3 / 0.7 (co-trimoxazole)

PO 160 mg/800 mg twice a day for 14 days

• fe (trimethoprim) = 0.7, fe (sulfamethoxazole) = 0.3, consider adjusting dose if CrCl reduced.
• Sulfamethoxazole is metabolised by CYP2C8/9 and conjugation.

Topic Code: 99249

must be prescribed or recommended by a consultant.