Ребенку показана антибиотикопрофилактика для искоренения носительства гемофильной палочки
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Цитата:
ANTIBIOTIC PROPHYLAXIS OF CLOSE CONTACTS — Before the routine use of H. influenzae type b (Hib) vaccines, a prospective study evaluated 4311 household contacts of 1147 patients with Hib meningitis for the development of invasive Hib disease within 30 days of the onset of illness in the index patient [ 64 ]. The risk of Hib meningitis among household contacts was 585 times the age-adjusted risk in the general population. The overall risk of invasive Hib disease among household contacts was 0. 21 percent; however, the risk varied according to age as follows:
0 to 11 months – 6 percent
12 to 23 months – 1.4 percent
24 to 47 months – 1.5 percent
48 to 71 months – 0.1 percent
≥6 years – 0 percent
If close contacts of the index case receive antimicrobial prophylaxis soon after the index case is diagnosed, pharyngeal carriage of Hib in the contact can be eradicated, thereby reducing the risk of developing invasive disease, and interrupting transmission. (See "Pathogenesis and pathophysiology of bacterial meningitis" .)
Цитата:
Antimicrobial prophylaxis
Chemoprophylaxis of close contacts eradicates nasopharyngeal carriage of Hib, thereby reducing the risk of developing invasive disease and/or transmission. (See 'Antibiotic prophylaxis of close contacts' above and "Pathogenesis and pathophysiology of bacterial meningitis" .)
To prevent invasive disease in susceptible children, we recommend chemoprophylaxis for close contacts of patients with invasive Hib disease who live in a household with a child who is younger than four years of age and has not received an age-appropriate number of doses of Hib conjugate vaccine, or an immunocompromised child ( Grade 1A ). (See 'Hib conjugate vaccine schedules' above and 'Close contact' above.)
We recommend chemoprophylaxis for child-care and preschool contacts when unimmunized or incompletely immunized children attend the facility and two or more cases of Hib invasive disease have occurred among attendees within 60 days ( Grade 1A ). (See 'Child care or preschool contacts' above.)
We recommend chemoprophylaxis for the index patient if he or she was treated with an agent other than cefotaxime or ceftriaxone and is younger than two years of age or lives in a household with a child <4 years of age who has not received an age-appropriate number of doses of Hib conjugate vaccine, or an immunocompromised child ( Grade 1A ). (See 'Hib conjugate vaccine schedules' above and 'Index patient' above.)
We recommend rifampin for Hib chemoprophylaxis ( Grade 1A ). The dose is 20 mg/kg (maximum dose 600 mg) once per day for four days. (See 'Recommended regimen' above.)
Для этого нужно провести курс лечения антибиотиком, активным против этого возбудителя, в идеале - эта активность должна быть подтверждена тестом на чувствительность к антибиотикам.
По окончании курса антибиотика, спустя 1-2 недели необходимо повторить мазок из носа для подтверждения эффективности антибиотикопрофилактики
За конкретными назначениями - обратитесь к своему педиатру
12.12.2014, 09:56
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