From the Guidelines
Benzathine penicillin or erythromycin are used to treat Diphtheria.
Treatment Options
- Benzathine penicillin is administered as an IM injection of 600,000 units for persons less than 6 years old and 1,200,000 units for those greater than or equal to 6 years old 1
- Erythromycin is given as a 7- to 10-day course of oral medication, with children receiving 40 mg/kg/day and adults receiving 1 g/day 1
Rationale
Erythromycin may be slightly more effective, but IM benzathine penicillin may be preferred due to avoiding possible noncompliance with a multi-day oral drug regimen 1.
Additional Considerations
In cases where the patient is infected with toxigenic Corynebacterium ulcerans, antibiotic treatment should follow clinical guidelines for patients infected with C. diphtheriae 1.
From the Research
Antibiotic Treatment for Diphtheria
The recommended first-line antibiotics for the treatment of diphtheria are:
- Penicillin
- Erythromycin 2, 3 These antibiotics are used in conjunction with diphtheria antitoxin to limit morbidity and reduce the duration of infection 4, 5.
Antibiotic Susceptibility
Studies have shown that the susceptibility pattern of Corynebacterium diphtheriae to erythromycin is better than that to penicillin 3.
- 85.2% of isolates were susceptible to erythromycin, with a MIC range of <0.016 to >256 μg/L
- 68.52% of isolates were susceptible to penicillin, with a MIC range of <0.016 to 2 μg/L 3
Importance of Antibiotic Treatment
Antibiotic treatment, in combination with diphtheria antitoxin, is essential for reducing the duration of infection and limiting morbidity 4, 5. The use of antibiotics, such as penicillin and erythromycin, can help to reduce the transmission of diphtheria and prevent outbreaks 4.