Table. Rabies Postexposure Prophylaxis (PEP) Schedule
|Not previously vaccinated||Wound cleansing||PEP should begin with immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent (e.g., providine-iodine solution) should be used to irrigate the wounds.|
|Human rabies immune globulin (HRIG)||Administer 20 IU/kg body weight. If anatomically feasible, the full dose should be infiltrated around and into the wound(s), and any remaining volume should be administered at an anatomic site (IM) distant from vaccination administration. Also, HRIG should not be administered in the same syringe as vaccine. Because HRIG might partially suppress active production of rabies virus antibody, no more than the recommended dose should be administered.|
|Vaccine||Human diploid cell vaccine (HDCV) or purified chick embryo cell vaccine (PCECV) 1.9 mL, IM (deltoid area†), one each on days 0,‡ 3, 7, and 14§|
|Previously vaccinated¶||Wound cleansing||PEP should begin with immediate thorough cleansing of all wounds with soap and water. If available, a virucidal agent (e.g., providine-iodine solution) should be used to irrigate the wounds.|
|HRIG Vaccine||HRIG should not be administered. HDCV or PCECV, 1.0 mL (deltoid area†), one each on days 0‡ and 3.|
*, These regimens are applicable for persons in all age groups, including children.
†, The deltoid area is the only acceptable site of vaccination for adults and older children. For younger children, the outer aspect of the thigh may be used. Vaccine should never be administered in the gluteal area.
‡, Day 0 is the day that dose 1 of vaccine is administered.
§, For persons with immunosuppression, rabies PEP should be administered, using all five doses of vaccine on days 0, 3, 7, 14, and 28.
¶, Any person with a history of preexposure vaccination with HDCV, PCECV, or rabies vaccine absorbed (RVA); prior to PEP with HDCV, PCECV or RVA; or previous vaccination with any other types of rabies vaccine and a documented history of antibody response to the prior vaccination.
Adapted from (Centers for Disease Control and Prevention: ACIP recommendations: Use of a reduced (4-dose) vaccine schedule for postexposure prophylaxis to prevent human rabies, 2011(http://www.cdc.gov/rabies/resources/acip_recommendations.html).
备注：表格摘自RAYMOND J. FONSECA等主编的Oral and Maxillofacial Trauma, 4th edition, Page 786.