Question:

A 3-week-old infant presents with a cough and sore throat. The mother reports that the infant develops a paroxysm of cough followed by apnea. The total leucocyte count is > 50,000 cells/μL. Which of the following drugs will you prescribe for this patient?

Updated On: Jun 18, 2025
  • Azithromycin
  • Amoxicillin
  • Cotrimoxazole
  • Clarithromycin
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The Correct Option is A

Solution and Explanation

The scenario presented describes a 3-week-old infant with symptoms highly suggestive of pertussis (whooping cough), characterized by a paroxysm of cough followed by apnea and a significantly elevated white blood cell count (leukocytosis) of > 50,000 cells/μL. In infants, pertussis can often present with severe symptoms, and immediate treatment is crucial to prevent complications.

Among the options provided:

  • Azithromycin: This macrolide antibiotic is the recommended first-line treatment for pertussis in infants and children. It is effective in eradicating Bordetella pertussis, the causative agent of pertussis.
  • Amoxicillin: Although effective against many bacterial infections, it is not the drug of choice for pertussis.
  • Cotrimoxazole: Not typically used for treating pertussis in infants.
  • Clarithromycin: Another macrolide that could be used for pertussis, but azithromycin is preferred, especially in infants due to its safety profile.

Therefore, the most appropriate medication for this infant is Azithromycin, given its efficacy and safety as a first-line treatment for pertussis in infants.

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