Materiały źródłowe

• #1 Diphtheria Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/782051-treatment

  Careful assessment of airway patency and cardiovascular stability. Patients should be transported to the nearest hospital. […] Treatment of diphtheria should be initiated even before confirmatory tests are completed due to the high potential for mortality and morbidity. […] Secure definite airway for patients with impending respiratory compromise or the presence of laryngeal membrane. Early airway management allows access for mechanical removal of tracheobronchial membranes and prevents the risk for sudden asphyxia through aspiration. […] Initiate prompt antibiotic coverage (erythromycin or penicillin) for eradication of organisms, thus limiting the amount of toxin production. Antibiotics hasten recovery and prevent the spread of the disease to other individuals. […] Neutralize the toxin as soon as diphtheria is suspected. Diphtheria antitoxin is a horse-derived hyperimmune antiserum that neutralizes circulating toxin prior to its entry into the cells. It prevents the progression of symptoms.

• #1 Diphtheria – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560911/

  Select appropriate interventions, including antitoxins and antibiotics, for treating diphtheria, considering individual patient factors. […] Coordinate care efforts for patients with diphtheria, emphasizing the importance of a cohesive and integrated healthcare approach. […] The primary treatment approaches for diphtheria involve promptly administering antitoxins and antibiotics. Additionally, the patient should undergo a thorough assessment for potential respiratory and cardiovascular instabilities. […] In suspected cases of diphtheria, antitoxin should be administered urgently based on clinical judgment without waiting for laboratory confirmation. […] Diphtheria antitoxin (DAT), derived from horse antiserum, is crucial in treatment. Antitoxin functions by neutralizing unbound diphtheria toxin circulating in the blood.

• #1 Clinical Guidance for Diphtheria | Diphtheria | CDC

  https://www.cdc.gov/diphtheria/hcp/clinical-guidance/index.html

  Treat respiratory diphtheria with antitoxin and antibiotics. […] Antibiotics alone are usually sufficient for cutaneous diphtheria. […] Only erythromycin or penicillin is recommended. […] Diphtheria antitoxin (DAT) is recommended. […] Antitoxin isn’t typically needed for cutaneous diphtheria. […] In the United States, healthcare providers can obtain diphtheria antitoxin from CDC on request.

• #1 Diphtheria – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/ddi/diphtheria/

  Diphtheria Treatment of Diphtheria […] Patients with suspected diphtheria infections should be placed in isolation, and any recent contacts should be notified. According to the CDC, clinicians should not wait for laboratory results before beginning treatment for diphtheria; they should immediately begin antibiotic therapy and administer diphtheria antitoxin (DAT) as soon as possible. Patients should receive supportive care as needed, including airway maintenance and respiratory support. Diphtheria antitoxin contains antibodies obtained from the serum of horses that have been immunized against diphtheria toxin. It does not neutralize toxin that is already fixed to tissue, but can neutralize circulating diphtheria toxin and prevent disease progression. Diphtheria antitoxin can be obtained only through the CDC via an investigational new drug protocol. Clinicians should call the CDCs Emergency Operations Center at 770-488-7100 to gain access to DAT and for updated information on the protocol for treating diphtheria.

• #1 Diphtheria – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/ddi/diphtheria/

  According to the CDC, clinicians should administer antimicrobial agents as soon as they suspect diphtheria infection. The preferred medications are penicillin or erythromycin. Diphtheria antitoxin may cause anaphylaxis in some patients, particularly those with a history of allergic rhinitis, asthma, or urticaria. In susceptible patients, anaphylaxis usually begins within minutes after exposure to DAT. The major manifestations include the following: Cutaneous: Pruritus, flushing, urticaria, and angioedema; Respiratory: Hoarse voice, stridor, wheeze, dyspnea, and cyanosis; and Cardiovascular: Rapid, weak pulse, hypotension, and arrhythmias. Treatment of anaphylaxis depends on its severity. Parenteral epinephrine is the primary medication for all types of anaphylactic reactions, and antihistamines also should be administered.

• #1 Diphtheria | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/diphtheria-16689456.html

  Diphtheria antitoxin (DAT) reduces mortality and should be given to all diphtheria patients. However, as supply is very limited, it may be necessary to define criteria and reserve DAT for the treatment of patients who will benefit the most from it. DAT can be administered to pregnant women. Administer DAT as soon as possible after disease onset. Do not wait for bacteriological confirmation; administer DAT under close monitoring in a hospital setting, according to the Besredka method to assess possibility of allergy. Any delay can diminish efficacy. […] Antibiotic treatment (as soon as possible without waiting for bacteriological confirmation) for 14 days or according to length of treatment recommended by the national protocol: if the patient can swallow: azithromycin PO (first-line) […] If the patient cannot swallow, start with one of the treatments below and change as soon as possible to oral route with one of the oral treatments above to complete 14 days of treatment: procaine benzylpenicillin IM […] In penicillin-allergic patients, use erythromycin IV. […] Intubation/tracheotomy if necessary (airway obstruction, respiratory failure, etc.).

• #1 Diphtheria – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560911/

  The antibiotics of choice for treating diphtheria are erythromycin or penicillin G. […] Early initiation of antibiotics is crucial to eliminate the organism promptly, limiting toxin release, expediting patient recovery, and preventing infection spread to close contacts. […] Close contacts, including household members and individuals in direct contact with the infected patient, should receive contact prophylaxis.

• #1 Diphtheria Medication: Antitoxins, Macrolides, Antibiotic, Penicillin

  https://emedicine.medscape.com/article/782051-medication

  Patients with active disease as well as all close contacts should be treated with antibiotics. Treatment is most effective in the early stages of disease and decreases the transmissibility and improves the course of diphtheria. […] Additionally, close contacts, such as family members, household contacts, and potential carriers, must receive chemoprophylaxis regardless of immunization status or age. This entails treatment with erythromycin or penicillin for 14 days and post treatment cultures to confirm eradication. […] The CDC has approved macrolides such as erythromycin as first-line agents for patients older than 6 months of age. However, macrolide therapy has been associated with an increase in pyloric stenosis in children younger than 6 months, especially treatment with erythromycin. Intramuscular penicillin is recommended for patients who will be noncompliant or intolerant to an erythromycin course.

• #1 Cutaneous diphtheria

  https://dermnetnz.org/topics/cutaneous-diphtheria

  Cutaneous diphtheria infection needs to be identified and treated to prevent spread of disease. Treatment includes: […] Antibiotics, such as erythromycin (40 mg/kg/day; maximum, 2 g/day) for 14 days […] An antitoxin to neutralise toxigenic systemic effects may be considered for membranous ulcers greater than 2 cm2 and in patients with systemic toxigenic symptoms […] Isolation to reduce the spread of disease. […] Cases are not contagious after 48 hours treatment with appropriate antibiotics. […] Vaccination is essential to promote herd immunity and to reduce the risk of transmission of C. diphtheriae. In New Zealand, vaccination against diphtheria is part of the National Immunisation Schedule and is given concurrently with tetanus and pertussis and sometimes also with polio, hepatitis B, and Haemophilus influenzae type b. […] The prognosis for uncomplicated cutaneous diphtheria is good, with most cases responding to oral antibiotics and simple wound care measures.

• #1 Diphtheria

  https://mobile.fpnotebook.com/ENT/Mouth/Dphthr.htm

  Droplet precautions […] Empiric treatment in suspected cases (do NOT delay treatment until culture confirmation) […] Diphtheria antitoxin (Equine serum from CDC) […] Inactivates circulating toxin before it damages heart and nerve tissue […] Antibiotics for 14 day duration […] Erythromycin 20 mg/kg/day divided every 6 hours IV or […] Penicillin G 50,000 units/kg up to 1.2 MU/day IV every 12 hours, then transition to Penicillin VK when able […] Culture and Treat contacts […] Procaine Penicillin for 1 dose OR […] Erythromycin for 7-10 days […] Without treatment, Diphtheria has a mortality rate as high as 50% […] With treatment, mortality may still approach 5-10% […] DTP Vaccination or DTaP Vaccination […] Also administer to recovered patients (infection does not ensure Immunity)

• #1 Clinical management of diphtheria: guideline, 2 February 2024 – World | ReliefWeb

  https://reliefweb.int/report/world/clinical-management-diphtheria-guideline-2-february-2024

  WHO has published the first-ever guidance on the clinical management of diphtheria. […] It addresses the use of Diphtheria Antitoxin (DAT) in the treatment of diphtheria. […] The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics. […] For patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.

• #1 Diphtheria : symptoms, treatment, prevention – Institut Pasteur

  https://www.pasteur.fr/en/medical-center/disease-sheets/diphtheria

  The standard treatment for diphtheria involves administering an antitoxin and/or a course of antibiotics as soon as possible. […] In addition to this, antibiotic therapy with amoxicillin is recommended, or therapy with macrolides if the patient is allergic to beta-lactam antibiotics. More information is available on the website of the National Reference Center (CNR) for Corynebacteria of the Diphtheriae Complex (in French) and in the guidelines published by the French High Council for Public Health (HCSP) on how to deal with a case of diphtheria.

• #1 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Diphtheria is an acute pharyngeal or cutaneous infection caused mainly by toxigenic strains of the gram-positive bacillus Corynebacterium diphtheriae and rarely by other, less common Corynebacterium species. […] Treatment is with antitoxin and penicillin or erythromycin. […] Diphtheria antitoxin must be given early without waiting for culture confirmation because the antitoxin neutralizes only toxin not yet bound to cells. […] Treat with diphtheria antitoxin and penicillin or erythromycin; document cure by culture. […] Antibiotics are required to eradicate the organism and prevent spread; they are not substitutes for antitoxin. […] For cutaneous diphtheria, thorough cleansing of the lesion with soap and water and administration of systemic antibiotics for 10 days are recommended. […] Vaccination is required after recovery for patients who had diphtheria because infection does not guarantee immunity.

• #1 About Diphtheria | Diphtheria | CDC

  https://www.cdc.gov/diphtheria/about/index.html

  Diphtheria is a serious bacterial disease that’s uncommon in the United States and usually associated with international travel. […] The best way to prevent diphtheria is to get vaccinated. CDC recommends diphtheria vaccination for everyone. […] Close contacts of someone with diphtheria should receive antibiotics to prevent them from getting sick. They should also be monitored for illness, tested for diphtheria, and vaccinated if their diphtheria vaccines aren’t up to date. […] Treatment usually involves diphtheria antitoxin and antibiotics. […] Generally, only antibiotics are used. […] Diphtheria antitoxin stops the toxin from causing more damage to the body. Antibiotics kill and get rid of the bacteria. […] Generally, people with diphtheria can’t infect others 48 hours after starting antibiotics. Finish taking all prescribed antibiotics though to make sure the bacteria are completely gone.

• #1 Diphtheria | Paramedic Kardex

  https://www.paramedickardex.com/copy-2-of-dico-handbook

  Diphtheria is an infection caused by the bacterium Corynebacterium diphtheriae. […] The best way to prevent diphtheria is to get vaccinated. There are four vaccines used to prevent diphtheria: DTaP, Tdap, DT, and Td. […] Recovery is typically a slow process with diphtheria. […] Post exposure prophylaxis for anyone who has encountered diphtheria includes immunization with the diphtheria toxoid or a booster if they have been previously vaccinated. After the provisional clinical diagnosis has been made and appropriate cultures are obtained, persons with suspected diphtheria should be given antitoxin and antibiotics in adequate dosages. […] The recommended antibiotic treatment for diphtheria is erythromycin, or penicillin. Diphtheria patients are usually kept in isolation, until they are no longer contagious this usually takes about 48 hours after initiation of the antibiotics. After the completion of antibiotic therapy, the doctor will run tests to make sure there is complete elimination of the organism, this should be verified by two consecutive negative cultures results.

• #1 Diphtheria – UF Health

  https://ufhealth.org/conditions-and-treatments/diphtheria

  If your provider thinks you have diphtheria, treatment will likely be started right away, even before test results come back. […] Diphtheria antitoxin is given as a shot into a muscle or through an IV (intravenous line). The infection is then treated with antibiotics, such as penicillin and erythromycin. […] You may need to stay in the hospital while getting the antitoxin. Other treatments may include: Fluids by IV, Oxygen, Bed rest, Heart monitoring, Insertion of a breathing tube, Correction of airway blockages. […] People without symptoms who carry diphtheria should be treated with antibiotics.

• #1 What to Know About Diphtheria

  https://www.webmd.com/a-to-z-guides/what-to-know-diphtheria-causes

  What Is the Treatment for Diphtheria? […] Diphtheria treatments include: […] Your doctor will give you drugs to combat the toxin that the bacteria makes. Theyll give you these medicines with a shot or an IV. Youll also need to take an antibiotic typically penicillin to kill any bacteria still in your system. […] Youll only need this if your symptoms are very severe and make it hard to breathe. […] Typically, youll need to rest for 4 to 6 weeks. […] No one can come near you while youre still infectious. […] The doctor will also need to treat your close family members if youre diagnosed with diphtheria. That involves making sure they all have the vaccine against diphtheria and giving them booster shots if they do. Theyll also get antibiotics to make sure that the bacteria doesnt spread.

• #1 Diphtheria – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diphtheria/diagnosis-treatment/drc-20351903

  Children and adults who have diphtheria often need to be in the hospital for treatment. They may be isolated in an intensive care unit because diphtheria can spread easily to anyone not vaccinated against the disease. […] If you’ve been exposed to a person infected with diphtheria, see a doctor for testing and possible treatment. Your doctor may give you a prescription for antibiotics to help prevent you from developing the disease. You may also need a booster dose of the diphtheria vaccine. […] People found to be carriers of diphtheria are treated with antibiotics to clear their systems of the bacteria as well. […] What treatments are available for diphtheria?

• #1 Diphtheria – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/738

  Diphtheria is a vaccine-preventable, toxin-mediated bacterial disease caused by Corynebacterium diphtheriae. […] Early intervention by administering antitoxin is key to preventing severe manifestations of the disease. Prompt administration of antitoxin is necessary to deactivate free toxin in serum before it enters cells. […] Antibiotic treatment is required to eliminate the bacteria and prevent further transmission. Protective immunity does not always develop after recovery, so toxoid vaccination of patients, contacts, and the general population is important for diphtheria prevention and control. […] To minimise transmission, patients with respiratory diphtheria require respiratory and contact precautions (including isolation, facemasks, gloves, and gowns), and those with cutaneous diphtheria require contact isolation, ideally until cultures taken after completion of therapy are negative.

• #1

  https://historyofvaccines.org/history/diphtheria/overview/

  Diphtheria treatment involves antibiotics to kill the diphtheria bacteria, plus antitoxin to neutralize the toxins secreted by the bacteria. […] Diphtheria patients are usually kept in isolation until they are no longer capable of infecting others, usually about 48 hours after antibiotic treatment begins.

• #1

  https://www.who.int/news-room/fact-sheets/detail/diphtheria

  The risk of complications or death decrease considerably if appropriate treatment is provided early in the course of illness. For this reason, if diphtheria is suspected, testing to confirm the disease should be done promptly and treatment should be started as soon as possible. […] Cases of diphtheria are usually treated with diphtheria antitoxin as well as antibiotics. Diphtheria specific antitoxin neutralizes circulation toxin in the blood. Detailed instructions for giving antitoxin can be found in the WHO treatment guidelines. Antibiotics stop bacterial replication and thereby toxin production, speed up getting rid of the bacteria and prevents transmission to others. However, many current strains of diphtheria have exhibited resistance to some commonly used antimicrobial drugs. […] Individuals who have been in contact with cases of diphtheria should be treated with antibiotics prophylactically to prevent illness. Their immunization status of all contacts should also be checked. If they are not fully vaccinated, they should also be offered vaccine.

• #1 Diphtheria Treatment & Management: Prehospital Care, Emergency Department Care, Consultations

  https://emedicine.medscape.com/article/782051-treatment

  Diphtheria disease does not confer immunity; thus, initiation or completion of immunization with diphtheria toxoid is necessary. […] Initiate antibiotic therapy with erythromycin or penicillin for chemoprophylaxis in a patient with suspected exposure. Throat cultures should be repeated in 2 weeks after treatment.

• #1

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/diphtheria.aspx

  Public health priority: Urgent. […] Treat case with antibiotics and consider diphtheria antitoxin urgently. […] Antibiotics should be given immediately but AFTER appropriate swabs are taken wherever possible. […] Generally, treatment should continue for 14 days. […] DAT is considered the mainstay of treatment for respiratory diphtheria. […] Antibiotics are required to eradicate the organism, stop further toxin production and help prevent transmission. […] Post infection administration of DAT reduces mortality by 76%. […] The treating clinician with specialist infectious disease advice as required will determine appropriate therapy for confirmed, probable and possible cases of diphtheria. […] If microbiological clearance by negative nasopharyngeal and throat culture is not achieved, an additional 10-day course of antibiotics is recommended. […] Cases of both cutaneous and respiratory diphtheria should be vaccinated in the convalescent phase of their disease as clinical infection may not induce adequate immunity. […] If a case received DAT, diphtheria vaccination should be delayed for four weeks.

• #1 Diphtheria | Doctor

  https://patient.info/doctor/diphtheria-and-diphtheria-vaccination

  Diphtheria anti-toxin (produced from horse serum) should be considered urgently for probable and confirmed cases of toxinogenic diphtheria. Diphtheria antitoxin significantly reduces morbidity and mortality from diphtheria. It is much more effective if given early, before diphtheria toxin has bound to tissues. […] Antibiotics are given to eliminate the organism and prevent spread. The antibiotics of choice are usually erythromycin, azithromycin, clarithromycin or penicillin. […] Patients should be immunised in the convalescent stage because clinical infection does not always induce adequate levels of antitoxin. They should receive a complete course or a reinforcing dose according to their age and immunisation history. […] Completely immunised individuals should receive a single reinforcing dose of a diphtheria-containing vaccine according to their age.

• #1 Diphtheria – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diphtheria/symptoms-causes/syc-20351897

  Diphtheria can be treated with medications. But in advanced stages, diphtheria can damage the heart, kidneys and nervous system. Even with treatment, diphtheria can be deadly, especially in children. […] With treatment, most people with diphtheria survive these complications, but recovery is often slow. Diphtheria is fatal about 5% to 10% of the time. Rates of death are higher in children under age 5 or adults older than age 40. […] Before antibiotics were available, diphtheria was a common illness in young children. Today, the disease is not only treatable but also preventable with a vaccine. […] The diphtheria vaccine is effective at preventing diphtheria. But there may be some side effects. Some children may experience a mild fever, fussiness, drowsiness or tenderness at the injection site after a DTaP shot. […] After the initial series of vaccinations in childhood, you need booster shots of the diphtheria vaccine to help you maintain your immunity. That’s because immunity to diphtheria fades with time.

• #1 Diphtheria (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/diphtheria.html

  With prompt care in a hospital, most patients recover from diphtheria. After the antibiotics and anti-toxin take effect, they will need bed rest for a while (4 to 6 weeks, or until full recovery). Bed rest is particularly important if someone develops myocarditis (inflammation of the heart muscle), which can be a complication of diphtheria. […] After recovery, people who had diphtheria should still get all the diphtheria vaccine shots to protect them from another infection. Having had the disease doesn’t guarantee lifetime immunity.

• #1 Diphtheria antitoxin treatment: from pioneer to neglected

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11752783/

  Today, no DAT treatment other than the classical eDAT one is approved for use, and none is even in phase II or III clinical trial evaluation. […] Diphtheria cases are rising worldwide, and are now observed in numbers unseen for two decades. Antitoxin therapy based on eDAT, a treatment invented in 1890, is still the only available treatment to specifically target the toxic effects of DT.

• #1 Diphtheria antitoxin treatment: from pioneer to neglected

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11752783/

  Attempts to purify and concentrate anti-DT antibodies from eDAT were therefore deployed. […] Here, we provide updates on diphtheria microbiology, epidemiology and clinical aspects, and present the history of the role of eDAT in diphtheria treatment, its challenges in terms of clinical use and procurement, and current research to find alternative anti-diphtheria treatments. […] eDAT is indicated for probable or confirmed cases of respiratory toxinic diphtheria in the majority of national guidelines, and in WHO guidelines. […] Today, the recommended treatment for diphtheria is antibiotic therapy, combined with eDAT in case or risk of toxinic signs. […] Adverse reactions to eDAT include anaphylaxis, early fever, serum sickness, aspecific mild cough and cutaneous reactions. […] The current eDAT active suppliers are, to our knowledge, Bulbio (Bulgaria), Instituto Butantan (Brazil), Premium Serums (India), Haffkine Biopharmaceuticals (India), biological E (India), Vins Bioproducts (India).

• #1 Diphtheria Antitoxin: Key Treatment for Diphtheria Infections – The Kingsley Clinic

  https://thekingsleyclinic.com/resources/diphtheria-antitoxin-key-treatment-for-diphtheria-infections/

  If diphtheria antitoxin is not suitable for you, alternative treatments or lifestyle changes may help manage diphtheria-related conditions. Always consult your healthcare provider before making any changes to your treatment plan. […] Recent research on diphtheria antitoxin aims to improve the safety and effectiveness of the treatment. Studies are exploring synthetic antitoxins that do not rely on animal-derived products, potentially reducing the risk of allergic reactions. Researchers are also investigating monoclonal antibodies as a possible alternative to traditional antitoxins.

• #1

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/diphtheria.html

  There are no antiviral drugs for treating diphtheria. […] The best prevention against diphtheria is immunization. There are four combination vaccines used to prevent diphtheria, tetanus and pertussis: DTaP, Tdap, DT, and Td.

• #2 Diphtheria – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diphtheria/diagnosis-treatment/drc-20351903

  If a doctor suspects diphtheria, treatment begins immediately, even before the results of bacterial tests are available. […] Diphtheria is a serious illness. Doctors treat it immediately and aggressively. Doctors first ensure that the airway isn’t blocked or reduced. In some cases, they may need to place a breathing tube in the throat to keep the airway open until the airway is less inflamed. Treatments include: […] Antibiotics, such as penicillin or erythromycin, help kill bacteria in the body, clearing up infections. Antibiotics lessen the time that someone with diphtheria is contagious. […] If a doctor suspects diphtheria, he or she will request a medication that counteracts the diphtheria toxin in the body. This medication comes from the Centers for Disease Control and Prevention. Called an antitoxin, this drug is injected into a vein or muscle.

• #2 Diphtheria – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/gram-positive-bacilli/diphtheria

  Diphtheria is an acute pharyngeal or cutaneous infection caused mainly by toxigenic strains of the gram-positive bacillus Corynebacterium diphtheriae and rarely by other, less common Corynebacterium species. […] Treatment is with antitoxin and penicillin or erythromycin. […] Diphtheria antitoxin must be given early without waiting for culture confirmation because the antitoxin neutralizes only toxin not yet bound to cells. […] Treat with diphtheria antitoxin and penicillin or erythromycin; document cure by culture. […] Antibiotics are required to eradicate the organism and prevent spread; they are not substitutes for antitoxin. […] For cutaneous diphtheria, thorough cleansing of the lesion with soap and water and administration of systemic antibiotics for 10 days are recommended. […] Vaccination is required after recovery for patients who had diphtheria because infection does not guarantee immunity.

• #2

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/diphtheria.aspx

  Public health priority: Urgent. […] Treat case with antibiotics and consider diphtheria antitoxin urgently. […] Antibiotics should be given immediately but AFTER appropriate swabs are taken wherever possible. […] Generally, treatment should continue for 14 days. […] DAT is considered the mainstay of treatment for respiratory diphtheria. […] Antibiotics are required to eradicate the organism, stop further toxin production and help prevent transmission. […] Post infection administration of DAT reduces mortality by 76%. […] The treating clinician with specialist infectious disease advice as required will determine appropriate therapy for confirmed, probable and possible cases of diphtheria. […] If microbiological clearance by negative nasopharyngeal and throat culture is not achieved, an additional 10-day course of antibiotics is recommended. […] Cases of both cutaneous and respiratory diphtheria should be vaccinated in the convalescent phase of their disease as clinical infection may not induce adequate immunity. […] If a case received DAT, diphtheria vaccination should be delayed for four weeks.

• #2 Diphtheria Medication: Antitoxins, Macrolides, Antibiotic, Penicillin

  https://emedicine.medscape.com/article/782051-medication

  The horse serum antitoxin is given to anyone suspected to have diphtheria and can be administered without confirmation from cultures, as it is most efficacious early during the course of the disease. […] Diphtheria antitoxin can be obtained only from the CDC. […] Erythromycin and penicillin are both recommended for the treatment of diphtheria. Some studies suggest that erythromycin may be better at eradication of the carrier state. […] Penicillin may be used for treatment, prophylaxis, and eradication of diphtheria in carriers. However, resistant strains and transmission from penicillin-treated carriers has been reported.

• #2 Diphtheria | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/healthyliving/diphtheria

  If diphtheria is suspected, treatment begins before the test results are back from the laboratory. Treatment may include: […] hospitalisation […] isolation to prevent the spread of infection […] antibiotics, such as penicillin, to destroy the bacteria […] diphtheria antitoxin given […] other medicines to reduce the risk of adverse reactions to the vaccine, for example corticosteroids, adrenaline or antihistamines […] surgery to remove the grey membrane in the throat, if necessary […] treatment of complications, for example medications to treat myocarditis […] bed rest for about six weeks or longer, depending on the severity of the illness.

• #2 Diphtheria | Apollo Hospitals

  https://www.apollohospitals.com/diseases-and-conditions/diphtheria/

  Diphtheria is a severe illness. Doctors treat it without delay and insistently with these medications: An Antitoxin: If doctors suspect diphtheria, the infected child or adult is given an antitoxin. The antitoxin, introduced into a vein or muscle, deactivates the diphtheria toxin already doing rounds in the body. Before giving an antitoxin, doctors may carry out skin allergy tests to ensure the infected person does not have a reaction to the antitoxin. People who are allergic must first be desensitized to the antitoxin. Doctors achieve this by primarily giving small doses of the antitoxin and then slowly but steadily increasing the dosage. […] Antibiotics: Diphtheria is also alleviated with antibiotics (penicillin or erythromycin). Antibiotics help exterminate bacteria in the body and clearing up infections. Children and adults who have diphtheria often need to get admitted in the hospital for treatment. They may be secluded in an intensive care unit as diphtheria can spread easily to anyone not immunized against the disease. Doctors may eliminate some of the substantial, gray covering in the throat if the layer is obstructing breathing.

• #2 About Diphtheria | Diphtheria | CDC

  https://www.cdc.gov/diphtheria/about/index.html

  Diphtheria is a serious bacterial disease that’s uncommon in the United States and usually associated with international travel. […] The best way to prevent diphtheria is to get vaccinated. CDC recommends diphtheria vaccination for everyone. […] Close contacts of someone with diphtheria should receive antibiotics to prevent them from getting sick. They should also be monitored for illness, tested for diphtheria, and vaccinated if their diphtheria vaccines aren’t up to date. […] Treatment usually involves diphtheria antitoxin and antibiotics. […] Generally, only antibiotics are used. […] Diphtheria antitoxin stops the toxin from causing more damage to the body. Antibiotics kill and get rid of the bacteria. […] Generally, people with diphtheria can’t infect others 48 hours after starting antibiotics. Finish taking all prescribed antibiotics though to make sure the bacteria are completely gone.

• #2 Diphtheria | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/diphtheria-16689456.html

  Diphtheria antitoxin (DAT) reduces mortality and should be given to all diphtheria patients. However, as supply is very limited, it may be necessary to define criteria and reserve DAT for the treatment of patients who will benefit the most from it. DAT can be administered to pregnant women. Administer DAT as soon as possible after disease onset. Do not wait for bacteriological confirmation; administer DAT under close monitoring in a hospital setting, according to the Besredka method to assess possibility of allergy. Any delay can diminish efficacy. […] Antibiotic treatment (as soon as possible without waiting for bacteriological confirmation) for 14 days or according to length of treatment recommended by the national protocol: if the patient can swallow: azithromycin PO (first-line) […] If the patient cannot swallow, start with one of the treatments below and change as soon as possible to oral route with one of the oral treatments above to complete 14 days of treatment: procaine benzylpenicillin IM […] In penicillin-allergic patients, use erythromycin IV. […] Intubation/tracheotomy if necessary (airway obstruction, respiratory failure, etc.).

• #2 Clinical manifestations, diagnosis, and treatment of diphtheria – UpToDate

  https://www.uptodate.com/contents/clinical-manifestations-diagnosis-and-treatment-of-diphtheria

  INTRODUCTION […] Diphtheria is an infectious disease caused by the gram-positive bacillus Corynebacterium diphtheriae. Infection may lead to respiratory disease, cutaneous disease, or an asymptomatic carrier state. The clinical manifestations, diagnosis, and treatment of diphtheria will be reviewed here. […] TREATMENT […] Approach to treatment […] Antitoxin […] Antibiotics […] Airway management […] Additional monitoring […] […] […] Respiratory diphtheria is typically caused by toxin-producing strains of C. diphtheriae; rarely, it is caused by toxigenic strains of other Corynebacterium species (C. ulcerans, C. hemolyticum, or C. pseudotuberculosis). Symptoms typically begin two to five days after infection. In addition to respiratory symptoms, absorption and dissemination of diphtheria toxin can lead to toxin damage of the heart (myocarditis), nervous system, and kidneys.

• #2 Cutaneous diphtheria

  https://dermnetnz.org/topics/cutaneous-diphtheria

  Cutaneous diphtheria infection needs to be identified and treated to prevent spread of disease. Treatment includes: […] Antibiotics, such as erythromycin (40 mg/kg/day; maximum, 2 g/day) for 14 days […] An antitoxin to neutralise toxigenic systemic effects may be considered for membranous ulcers greater than 2 cm2 and in patients with systemic toxigenic symptoms […] Isolation to reduce the spread of disease. […] Cases are not contagious after 48 hours treatment with appropriate antibiotics. […] Vaccination is essential to promote herd immunity and to reduce the risk of transmission of C. diphtheriae. In New Zealand, vaccination against diphtheria is part of the National Immunisation Schedule and is given concurrently with tetanus and pertussis and sometimes also with polio, hepatitis B, and Haemophilus influenzae type b. […] The prognosis for uncomplicated cutaneous diphtheria is good, with most cases responding to oral antibiotics and simple wound care measures.

• #2 Diphtheria: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/159534

  Without treatment, diphtheria can be fatal for up to 50% of people. […] Treatment aimed at countering the bacterial effects has two components: Antitoxin: This is also known as anti-diphtheritic serum. It neutralizes the bacterias toxins. Doctors use the antitoxin to treat diphtheria that has affected the respiratory system. […] Antibiotics: Erythromycin or penicillin can eradicate the bacteria and stop them from spreading. Antibiotics can treat diphtheria affecting the respiratory system and skin. […] Early treatment with antitoxin is important, and doctors typically start it before the culture comes back. The antitoxin only works on toxins that have not yet bound with cells and tissue in the body. […] People are no longer contagious after taking antibiotics for 48 hours. However, it is important that a person finishes the full course of antibiotics. […] If a person presents with symptoms of diphtheria, a doctor can often diagnose the condition with an examination and a bacterial culture. Early treatment can help prevent major complications.

• #2 Diphtheria – Wikipedia

  https://en.wikipedia.org/wiki/Diphtheria

  A diphtheria vaccine is effective for prevention, and is available in a number of formulations. […] Diphtheria can be prevented in those exposed, as well as treated with the antibiotics erythromycin or benzylpenicillin. […] In severe cases a tracheotomy may be needed to open the airway. […] The disease may remain manageable, but in more severe cases, lymph nodes in the neck may swell, and breathing and swallowing are more difficult. People in this stage should seek immediate medical attention, as obstruction in the throat may require intubation or a tracheotomy. […] Patients with severe cases are put in a hospital intensive care unit, and given diphtheria antitoxin (consisting of antibodies isolated from the serum of horses that have been challenged with diphtheria toxin). […] Therefore, the decision to administer diphtheria antitoxin is based on clinical diagnosis, and should not await laboratory confirmation.

• #2 Diphtheria – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/738

  Diphtheria is a vaccine-preventable, toxin-mediated bacterial disease caused by Corynebacterium diphtheriae. […] Early intervention by administering antitoxin is key to preventing severe manifestations of the disease. Prompt administration of antitoxin is necessary to deactivate free toxin in serum before it enters cells. […] Antibiotic treatment is required to eliminate the bacteria and prevent further transmission. Protective immunity does not always develop after recovery, so toxoid vaccination of patients, contacts, and the general population is important for diphtheria prevention and control. […] To minimise transmission, patients with respiratory diphtheria require respiratory and contact precautions (including isolation, facemasks, gloves, and gowns), and those with cutaneous diphtheria require contact isolation, ideally until cultures taken after completion of therapy are negative.

• #2 Diphtheria – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diphtheria/diagnosis-treatment/drc-20351903

  Children and adults who have diphtheria often need to be in the hospital for treatment. They may be isolated in an intensive care unit because diphtheria can spread easily to anyone not vaccinated against the disease. […] If you’ve been exposed to a person infected with diphtheria, see a doctor for testing and possible treatment. Your doctor may give you a prescription for antibiotics to help prevent you from developing the disease. You may also need a booster dose of the diphtheria vaccine. […] People found to be carriers of diphtheria are treated with antibiotics to clear their systems of the bacteria as well. […] What treatments are available for diphtheria?

• #2 What to Know About Diphtheria

  https://www.webmd.com/a-to-z-guides/what-to-know-diphtheria-causes

  If you get treatment, its possible to fully recover from diphtheria. Your recovery time will usually take from 4 to 6 weeks. […] The CDC says that with treatment, about 9 in 10 people will survive a case of respiratory diphtheria. But up to half of people with the disease who dont get treatment for it can die from it, the agency says.

• #2 Diphtheria is back in Australia, here’s why – and how vaccines can prevent its spread | NCIRS

  https://ncirs.org.au/diphtheria-back-australia-heres-why-and-how-vaccines-can-prevent-its-spread

  Antibiotics are given to people with diphtheria but may not have much impact on the disease once established. […] Specialised treatment with diphtheria antitoxin (DAT) is often required to counteract the effects of the toxin. DAT needs to be given early in the illness (within 48 hours). […] However there are global shortages of DAT due to decreased production over recent decades.

• #2 Factsheet about diphtheria

  https://www.ecdc.europa.eu/en/diphtheria/facts

  Diphtheria can be treated with antitoxin and antibiotics. […] An effective vaccine is available against diphtheria and mass immunisation has led to the reduction in the number of cases in Europe.

• #3 Diphtheria Treatments and Prevention | Smithsonian Institution

  https://www.si.edu/spotlight/antibody-initiative/diphtheria

  Diphtheria is caused by bacteria. However, it is the toxins produced by the bacteria, rather than the bacteria themselves, that primarily cause symptoms. […] Currently, all three of these diseases can be addressed by a single, combined vaccine. […] The manufacturer of the product claimed that the fumes produced by the pastilles could both prevent and treat diphtheria by destroying all contagious, putrefactive and disease-bearing germs. […] The CDC reports that about 50% of victims who do not receive treatment are killed by the disease. Of those who do receive treatment, 10% still die. […] In order to try to save a patient from suffocation by the pseudomembrane, doctors performed tracheotomy or intubation procedures. […] In 1890, an effective treatment for diphtheria antitoxin was discovered by Shibasaburo Kitasato and Emil von Behring in Germany. Pharmaceutical companies and public health agencies began to produce the new serum therapy in earnest.

• #3 Diphtheria antitoxin treatment: from pioneer to neglected

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11752783/

  Diphtheria, a severe respiratory infection, was a major killer of children until the early years of the 20th century. […] The pathological effects caused by its main virulence factor, diphtheria toxin, can be diminished by passive transfer of antibodies. Equine diphtheria antitoxin (eDAT), the cornerstone of treatment against toxinic complications of diphtheria, was invented more than 130 years ago, in 1890, and is still in use today. […] The burden of diphtheria has been largely reduced thanks to large-scale vaccination against diphtheria toxin (DT), antimicrobial therapy, and a therapeutic product specific to this disease, known as diphtheria antitoxin (DAT), or more specifically equine DAT (eDAT) when obtained from horses. […] Today, eDAT still remains critical to reduce morbidity and mortality caused by the effect of diphtheria toxin on the human body.

• #3 Diphtheria: View Causes, Symptoms and Treatments | 1mg

  https://www.1mg.com/diseases/diphtheria-355?srsltid=AfmBOoqT4Yqm-Yu488NloA89yjYoOo2rWbab0rqtFcM39VxGQYb2L0ca

  If diphtheria is suspected, the treatment usually begins before the confirmation of laboratory tests to avoid any complications. […] Hospitalization of the patient […] Isolation to reduce the transmission […] Other medicines such as corticosteroids, adrenaline or antihistamines to reduce any severe reaction to the antitoxin given […] Tracheostomy (surgical insertion of a tube in the windpipe), in case of severe breathing difficulties […] Surgery to remove the gray membrane in the throat, if necessary […] Treatment of complications, for example medications to treat myocarditis (inflammation of the heart) […] Bed rest for about one month or longer, for complete recovery […] Cleaning sores with soap and water, in case of skin diphtheria.

• #4 Diphtheria – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/ddi/diphtheria/

  Diphtheria Treatment of Diphtheria […] Patients with suspected diphtheria infections should be placed in isolation, and any recent contacts should be notified. According to the CDC, clinicians should not wait for laboratory results before beginning treatment for diphtheria; they should immediately begin antibiotic therapy and administer diphtheria antitoxin (DAT) as soon as possible. Patients should receive supportive care as needed, including airway maintenance and respiratory support. Diphtheria antitoxin contains antibodies obtained from the serum of horses that have been immunized against diphtheria toxin. It does not neutralize toxin that is already fixed to tissue, but can neutralize circulating diphtheria toxin and prevent disease progression. Diphtheria antitoxin can be obtained only through the CDC via an investigational new drug protocol. Clinicians should call the CDCs Emergency Operations Center at 770-488-7100 to gain access to DAT and for updated information on the protocol for treating diphtheria.

• #5 Diphtheria – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/738

  Diphtheria is a vaccine-preventable, toxin-mediated bacterial disease caused by Corynebacterium diphtheriae. […] Early intervention by administering antitoxin is key to preventing severe manifestations of the disease. Prompt administration of antitoxin is necessary to deactivate free toxin in serum before it enters cells. […] Antibiotic treatment is required to eliminate the bacteria and prevent further transmission. Protective immunity does not always develop after recovery, so toxoid vaccination of patients, contacts, and the general population is important for diphtheria prevention and control. […] To minimise transmission, patients with respiratory diphtheria require respiratory and contact precautions (including isolation, facemasks, gloves, and gowns), and those with cutaneous diphtheria require contact isolation, ideally until cultures taken after completion of therapy are negative.

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