What is the role of chemoprophylaxis in the management of Haemophilus influenzae infections?

Updated: Jul 02, 2019
  • Author: Joseph Adrian L Buensalido, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Answer

Unvaccinated or undervaccinated children younger than 4 years who have household contact with an index patient have a 600-fold increased risk of Hib disease.

Begin chemoprophylaxis as soon as possible because the risk of secondary disease is greatest within a few days after disease onset in the index case. Rifampin is the drug of choice for chemoprophylaxis because it achieves high bactericidal concentrations intracellularly and in mucosal secretions, thereby eradicating 95% of Hib from the nasopharynx. Administer rifampin to all household contacts, including adults, children, and the index patient, if a close household contact is immunocompromised, regardless of immunization status; younger than 48 months and is not completely immunized or unimmunized; or younger than 12 months and has not received the 2- to 3-dose primary series. Chemoprophylaxis is not needed in contacts of patients with non-Hib invasive disease. [94]


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