Treatment of diphtheria in children

The success of treating diphtheria in a child depends mainly on the timely administration of antitoxic diphtheria serum. Early administration and sufficient doses of serum provide a favorable outcome even in severe toxic forms. Purified concentrated liquid equine diphtheria serum is used. To prevent anaphylactic shock, the first administration of the serum is done according to the Bezredka method (0.1 ml of diphtheria serum diluted 100 times is administered strictly intradermally into the flexor surface of the forearm; if the test is negative, 0.1 ml of undiluted serum is administered subcutaneously and, if there are no symptoms of anaphylactic shock, the remaining dose is administered intramuscularly after 30 minutes). The doses of diphtheria serum depend on the form, severity, day of the disease and, to some extent, on the age of the patient. Only for children aged 1 and 2 years is the dose reduced by 1.5-2 times.

• For localized forms of diphtheria of the oropharynx, nose and larynx, the serum is usually administered once at a dose of 10,000-30,000 AE, but if the effect is insufficient, the administration is repeated after 24 hours.
• In the case of widespread and subtoxic forms of diphtheria of the oropharynx, as well as widespread croup, treatment with antidiphtheria serum is continued for 2 days. Administer 30,000-40,000 AE once a day.
• In toxic diphtheria of the oropharynx of grades I and II, the average dose of antidiphtheria serum per course of treatment is 200,000-250,000 AE. In the first two days, the patient must be administered 3/4 of the course dose. In the first day, the serum is administered 2 times with an interval of 12 hours.
• In toxic stage III and hypertoxic, as well as in the combined form, the course dose can be increased to 450,000 AE. On the first day, half of the course dose is administered in 3 doses with an interval of 8 hours. A third of the daily dose can be administered intravenously. The administration of the serum is stopped after the disappearance of fibrinous deposits. Along with the serum, antibiotics (macrolides or cephalosporins) are prescribed in generally accepted doses orally, intramuscularly or intravenously for 5-7 days.

Treatment of carriers of bacteria

First of all, general strengthening therapy and sanitation of chronic foci of the nasopharynx should be carried out. Vitamins are prescribed, proper nutrition and walks are provided. In case of long-term carriage, erythromycin or other macrolides are given orally for 7 days. More than 2 courses of antibacterial therapy should not be carried out.