Which medications are used in the treatment of diphtheria?

Updated: Jan 18, 2019
  • Author: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

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. [3]

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.

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. For more information regarding acquisition, see the CDC website for diphtheria antitoxin.


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