From the Guidelines
The immediate treatment for a child infected with diphtheria involves prompt administration of diphtheria antitoxin and antibiotics, with erythromycin or penicillin G being the preferred options, as they eliminate the bacteria, stop toxin production, and reduce communicability 1. The dose of diphtheria antitoxin depends on the severity and duration of illness, typically ranging from 20,000 to 120,000 units given intravenously. Antibiotics such as erythromycin (40-50 mg/kg/day divided into four doses for 14 days) or penicillin G (100,000-150,000 units/kg/day divided into four doses for 14 days) are essential in the treatment of diphtheria. The child should be isolated, with airway management provided if there's respiratory compromise. Some key points to consider in the treatment of diphtheria include:
- Close contacts should receive prophylactic antibiotics, such as erythromycin (40 mg/kg/day for children) or benzathine penicillin (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), and be monitored for symptoms 1.
- Vaccination status should be updated after recovery, as having diphtheria doesn't always confer immunity.
- Diphtheria toxin can cause severe complications, including myocarditis and peripheral neuropathy, if treatment is delayed 1. It is crucial to prioritize the treatment of diphtheria, as the disease can have severe consequences, including high morbidity and mortality rates, especially in unvaccinated or inadequately vaccinated individuals 1.
From the FDA Drug Label
Diphtheria: Infections due to Corynebacterium diphtheriae, as an adjunct to antitoxin, to prevent establishment of carriers and to eradicate the organism in carriers. The immediate treatment for a child infected with diphtheria involves the use of antitoxin as the primary treatment, with erythromycin used as an adjunct to prevent the establishment of carriers and to eradicate the organism in carriers 2.
- The treatment should be administered under the guidance of a healthcare professional.
- Erythromycin is used to treat the infection caused by Corynebacterium diphtheriae, but it is not a replacement for antitoxin.
- It is essential to follow the prescribed treatment regimen and dosage instructions to ensure effective treatment and prevent complications.
From the Research
Immediate Treatment for Diphtheria in Children
The immediate treatment for a child infected with diphtheria involves:
- Swift administration of diphtheria antitoxin (DAT) with conjunct antibiotic therapy, as stated in 3
- Use of a hyperimmune serum neutralizing diphtheria toxin and subsequent antibiotic therapy, such as penicillin, as mentioned in 4
- Administration of antibiotics inhibiting bacterial protein synthesis, such as clindamycin or linezolid, as an alternative to penicillin, as suggested in 4
- Treatment with erythromycin, which has been shown to be effective in some cases, although it may have a slower fever clearance time compared to penicillin, as reported in 5
Complications of Diphtheria in Children
Complications of diphtheria in children may include:
- Myocarditis, which is associated with increased fatality risk, as mentioned in 6
- Neuropathy, which can occur due to the diphtheria toxin, as stated in 6
- Formation of a pseudomembrane in the throat, which can lead to respiratory complications, as described in 6
- Cutaneous infections, which are possible although less common, as noted in 6
Importance of Timely Treatment
Timely administration of diphtheria antitoxin and antimicrobial therapy is crucial in treating diphtheria, as emphasized in 3 and 6. Effective vaccines are available, but the disease can still re-emerge in areas where vaccination programs are not sustained, highlighting the need for proper clinical and epidemiological investigations, as mentioned in 6 and 7.