Rosh Pediatrics Practice Exam

What is the recommended treatment for a 3-year-old who has a prolonged cough followed by a Whoop, indicative of pertussis?

1. A single dose of dexamethasone given orally

2. Antipyretic, oral rehydration, and cool mist humidifier therapy at home

3. Azithromycin 150 mg orally on day 1 and 75 mg orally on days 2-5

4. Trimethoprim-sulfamethoxazole 160-800 mg orally twice a day

The correct answer is: Azithromycin 150 mg orally on day 1 and 75 mg orally on days 2-5

The recommended treatment for a 3-year-old with a prolonged cough followed by a whoop, indicative of pertussis, is azithromycin. This choice is appropriate because pertussis, also known as whooping cough, is a bacterial infection caused by Bordetella pertussis. Early treatment with antibiotics such as azithromycin is crucial for reducing the severity and duration of the disease, as well as for preventing the spread of the infection to others, especially vulnerable populations like infants. Azithromycin is preferred in young children and infants due to its safety profile and effectiveness in treating pertussis. The recommended dosage for the treatment of pertussis in children is an initial 150 mg on the first day, followed by 75 mg for the next four days. This dosing schedule helps to eradicate the bacteria from the respiratory tract and alleviates symptoms more swiftly than allowing the infection to resolve on its own. The other treatments mentioned, such as dexamethasone, are not indicated for pertussis. Dexamethasone is typically used for conditions involving inflammation, like croup, but not for bacterial infections like pertussis. Antipyretics and hydration are supportive measures that can provide comfort but do not target