Revision as of 20:26, 6 August 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Kalsang Dolma, M.B.B.S.[2]

Medical Therapy=

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^[1] ^[2]

1. Antitoxin

1.1 Pharyngeal disease <48 hrs

Preferred regimen: 20,000-40,000 U IV/IM

1.2 Nasopharyngeal

Preferred regimen: 40-60,000 U IV/IM

1.3 Extensive disease, or > 72 hrs

Preferred regimen: 80-120,000 U IV/IM

Note: IV administration for severe disease

2. Antibiotics

Preferred regimen: Erythromycin 40 mg/kg/day (Maximum, 2 gm/day) PO/IV for 14 days
Alternative regimen: Procaine penicillin G 600,000 U/day IM qd for 14 days
Note: Procaine penicillin G 300,000 U/day for those weighing 10 kg or less

3. Preventive antibiotic use

Note: For close contacts, especially household contacts, a diphtheria booster, appropriate for age, should be given
Preferred regimen: Benzathine penicillin G

younger than 6 years old: 600,000 U IM
6 years old and older: 1,200,000 U IM

Alternative regimen: Erythromycin

Adult: 1 g/day PO 7-10 days

Pediatric: 40 mg/kg/day PO 7-10 days

Note (1): If surveillance of contacts cannot be maintained, they should receive benzathine penicillin G
Note (2): Maintain close surveillance and begin antitoxin at the first signs of illness

References

↑ Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.
↑ "Diphtheria CDC".

Template:WikiDoc Sources

[1] Bartlett, John (2012). Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases. Burlington, MA: Jones and Bartlett Learning. ISBN 978-1449625580.

[2] "Diphtheria CDC".

[1]

[2]

@@ Line 3: / Line 3: @@
 {{CMG}} {{AE}} {{KD}}
-==Medical Therapy==
-The disease may remain manageable, but in more severe cases [[lymph nodes]] in the neck may swell, and breathing and swallowing will be more difficult. People in this stage should seek immediate medical attention, as obstruction in the throat may require [[intubation]] or a [[tracheotomy]]. In addition, an increase in heart rate may cause cardiac arrest. Diphtheria can also cause paralysis in the eye, neck, throat, or respiratory muscles. Patients with severe cases will be put in a hospital [[intensive care unit]] (ICU) and be given a diphtheria anti-toxin. Since antitoxin does not neutralize toxin that is already bound to tissues, delaying its administration is associated with an increase in mortality risk. Therefore, the decision to administer diphtheria antitoxin is based on clinical diagnosis, and should not await laboratory confirmation.
-Antibiotics have not been demonstrated to affect healing of local infection in diphtheria patients treated with antitoxin. Antibiotics are used in patients or carriers to eradicate ''C. diphtheriae'' and prevent its transmission to others. The CDC recommends<ref>''The first version of this article was adapted from the [[Centers for Disease Control and Prevention|CDC]] document "Diphtheria - 1995 Case Definition" athttp://www.cdc.gov/epo/dphsi/casedef/diphtheria_current.htm. As a work of an agency of the U.S. Government without any other copyright notice it should be available as a public domain resource''.</ref> either:
+=Medical Therapy==
-* [[Erythromycin]] (orally or by injection) for 14 days (40 mg/kg per day with a maximum of 2 g/d), or
+<ref>{{cite book | last = Bartlett | first = John | title = Johns Hopkins ABX guide : diagnosis and treatment of infectious diseases | publisher = Jones and Bartlett Learning | location = Burlington, MA | year = 2012 | isbn = 978-1449625580 }}</ref> <ref>{{cite web | title = Diphtheria CDC| url =http://www.cdc.gov/vaccines/pubs/pinkbook/dip.html }}</ref>
-* [[Procaine penicillin G]] given intramuscularly for 14 days (300,000 U/d for patients weighing <10 kg and 600,000 U/d for those weighing >10 kg). Patients with allergies to penicillin G or erythromycin can use [[rifampin]] or [[clindamycin]].
+::* 1. '''Antitoxin '''
+:::* 1.1 '''Pharyngeal disease <48 hrs'''
+::::* Preferred regimen: 20,000-40,000 U IV/IM
+:::* 1.2 '''Nasopharyngeal'''
+::::* Preferred regimen: 40-60,000 U IV/IM
+:::* 1.3 '''Extensive disease, or > 72 hrs'''
+::::* Preferred regimen: 80-120,000 U IV/IM
+:::* Note: IV administration for severe disease
+::* 2. '''Antibiotics '''
+:::* Preferred regimen: [[Erythromycin]] 40 mg/kg/day (Maximum, 2 gm/day) PO/IV for 14 days
+:::* Alternative regimen: [[Procaine penicillin G]] 600,000 U/day IM qd for 14 days
+:::* Note: Procaine penicillin G  300,000 U/day for those weighing 10 kg or less
+::* 3. '''Preventive antibiotic use'''
+:::* Note: For close contacts, especially household contacts, a diphtheria booster, appropriate for age, should be given
+:::* Preferred regimen: [[Benzathine penicillin G ]]
+::::* younger than 6 years old: 600,000 U IM
+::::* 6 years old and older: 1,200,000 U IM
+:::* Alternative regimen: [[Erythromycin]]
+::::* Adult: 1 g/day PO 7-10 days
+::::* Pediatric: 40 mg/kg/day PO 7-10 days
+:::* Note (1): If surveillance of contacts cannot be maintained, they should receive benzathine penicillin G
+:::* Note (2): Maintain close surveillance and begin antitoxin at the first signs of illness
 ==References==

Diphtheria medical therapy: Difference between revisions

Revision as of 20:26, 6 August 2015

Medical Therapy=

References

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