ACIP Recommendations: Immunobiologics and Schedules for ...



ACIP Recommendations: Immunobiologics and Schedules for HCW Post-Exposure Prophylaxis

|Disease |Prophylaxis |Indications |Contra-Indications |Special Considerations|

|Diphtheria |Benzathine penicillin, 1.2 |Exposure to diphtheria or | |Also administer one |

| |mU, single dose, or |identified as a carrier | |dose Td to previously |

| |erythromycin (1gm/day) PO x | | |immunized if no Td has|

| |7 days | | |been given in > 5 yr |

|Hepatitis A |One IM dose IG 0.02 ml/kg |Exposure to feces of |IgA deficiency; do not give| |

| |given within 2 wk of |infected persons or during |within 2 wk after MMR or 3 | |

| |exposure in large muscle |outbreaks |wk after varicella vaccine | |

| |mass (deltoid, gluteal) | | | |

|Hepatitis B |HBIG 0.06 ml/kg IM ASAP |HBV susceptible with | |If HBV series has not |

| |(within 7 days) after |percutaneous or | |been started, give 2nd|

| |exposure (with one dose HBV |mucous-membrane exposure to | |dose of HBIG one month|

| |given at a different site) |blood known to be HBsAg | |after 1st. |

| | |seropositive | | |

|Meningococcal Disease |Rifampin, 600 mg PO q 12 hr |Direct contact with |Rifampin and ciprofloxacin | |

| |x 2 days, or ceftriaxone, |respiratory secretions from |not recommended during | |

| |250 mg IM, single dose, or |infected pts (CPR, |pregnancy | |

| |ciprofloxacin 500 mg PO, |endotracheal tube mgmt., or | | |

| |single dose |close examination of the | | |

| | |oropharynx) | | |

|Pertussis |Erythromycin, 500 mg qid PO,|Direct contact with | | |

| |or |respiratory secretions/ large| | |

| |triethoprim-sulfamethoxazole|aerosol droplets from | | |

| |, 1 tablet bid PO, for 14 |infected pts | | |

| |days after exposure | | | |

|Disease |Prophylaxis |Indications |Precautions/ |Special Considerations |

| | | |Contraindications | |

|Rabies |Never vaccinated: HRIG |HCWs bitten by human or animal | |HCWS who have previously |

| |20 IU/kg, half |with rabies, or have scratches, | |been vaccinated, give HDCV|

| |infiltrated around the |abrasions, open wounds, or mucous | |or RVA vaccine, 1.0 ml, |

| |wound, and HDCV or RVA |membranes contaminated with saliva| |IM, on days 0 and 3; no |

| |vaccine, 1.0 ml, IM |or other potentially infective | |HRIG is necessary |

| |(deltoid), 1 each on |material (brain tissue) | | |

| |days 0,3,7,14, and 28 | | | |

|Varicella zoster |VZIG for HCWs 50 kg: 625U+ |have close and prolonged exposure | |administer VZIG; if |

| | |to an infectious HCW or pt., | |varicella is prevented by |

| | |particularly those at high risk | |the use of VZIG, vaccine |

| | |for complications, | |should be offered later |

| | |(pregnant or immunocompromised) | | |

Hospital Infection Control Practices Advisory Committee, Centers for Disease Control and Prevention, Public Health Service, US Department of Health and Human Services. Guideline for Infection Control in Health Care Personnel, 1998.

Reviewed: 2007

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