When is inpatient care indicated for the treatment of pertussis (whooping cough)?

Updated: May 02, 2019
  • Author: Joseph J Bocka, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Inpatient care is required for patients with pertussis who have intractable nausea and vomiting, failure to thrive, seizures, or encephalopathy or for patients with sustained hypoxemia during coughing paroxysms who require supplemental oxygen.

Hospitalization should be strongly considered for patients at risk for severe disease and complications, including infants younger than 3 months; infants aged 3-6 months, unless observed paroxysms are not severe; premature young infants; and infants or children with underlying pulmonary, cardiac, or neuromuscular disease.

Patients with pneumonia, apneic or cyanotic spells, hypoxia, or moderate to severe dehydration should also be considered for admission. Patients who are severely ill may require treatment in an intensive care unit (ICU).

For the hospitalized patient, in addition to standard precautions, droplet precautions are recommended for 5 days after initiation of effective therapy or until 3 weeks after the onset of paroxysms if appropriate antimicrobial therapy is not given.


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