Chief Complaint: Cough
Determining the Cause
a. History: Cough that is not improving after 3 days
Differential Diagnosis
Pertussis*,
Age less than 4 months
*Management: A definite diagnosis is not yet established at this point but for Age <4 months suspected pertussis is an indication for hospitalization in infants with pertussis or suspected pertussis infection given the concerns for rapid deterioration. Infants younger than four months are at increased risk for severe or fatal pertussis infection [45-47]. In a review of 53 fatal cases of pertussis in infants younger than four months from a single state (1998 to 2014), the case fatality rate was 1.2 percent; 47 of the infants were younger than two months at the time of illness onset [48].
Infants 1 to <6 months: Oral, IV: 10 mg/kg/dose once daily for 5 days.
Infants ≥6 months, Children, and Adolescents: Oral, IV: 10 mg/kg once on day 1 (maximum dose: 500 mg/dose), followed by 5 mg/kg/dose once daily on days 2 to 5 (maximum dose: 250 mg/dose).