TABLE 5.

Antimicrobial agents for treatment and postexposure prophylaxis for B. pertussis infection, 1997 to 2013^a

Agent (reference[s])	Age group	Dosing information	Comments
Erythromycin (220, 278, 332, 336, 344–346, 663)	>1 mo	40–60 mg/kg/day in 3 or 4 divided doses for 7–14 days	Drug-drug interaction with those metabolized by cytochrome P450; poorly tolerated (e.g., GI upset, hypersensitivity reactions, cholestatic hepatitis, sensorineural hearing loss)
	Adults	500 mg every 6 or 8 h for 7–14 days	Increased risk of IHPS in neonates; FDA pregnancy category B drug
Azithromycin (220, 278, 332, 336, 337)	<6 mo	10 mg/kg daily for 5 days	Well tolerated but GI upset can still occur; Drug-drug interaction with those metabolized by cytochrome P450
	≥6 mo	10 mg/kg on day 1, followed by 5 mg/kg on days 2–5	Administer 1 h before or 2 h after food and antacids
	Adults	500 mg on day 1, followed by 250 mg on days 2–5	FDA pregnancy category B drug
Clarithromycin (220, 278, 332, 337)	>1 mo	15 mg/kg/day in 2 divided doses for 7 days	Moderately tolerated (GI upset is common)
	Adults	500 mg every 12 h for 7 days	Drug-drug interaction with those metabolized by cytochrome P450; FDA pregnancy category C drug
TMP-SMZ (278)	>2 mo	TMP at 8 mg/kg/day plus SMZ at 40 mg/kg/day every 12 h for 14 days	Second-line treatment for those who have macrolide resistance or intolerance; FDA pregnancy category C drug
	Adults	TMP at 320 mg/day plus SMZ at 1,600 mg/day every 12 h for 14 days	Contraindicated in pregnant women and breastfeeding mothers

^aGI, gastrointestinal; FDA, Food and Drug Administration; IHPS, infantile hypertrophic pyloric stenosis; TMP-SMZ, trimethoprim-sulfamethoxazole (co-trimoxazole).