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Treatment of diphtheria in children
Last reviewed: 19.11.2021
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The success of treating diphtheria in a child depends mainly on the timely administration of antitoxic antidiphtheria serum. Early administration and sufficient serum doses provide a favorable outcome even in severe toxic forms. Serum antidiphtherist equine purified concentrated liquid is used. To prevent anaphylactic shock, the first injection of serum is done by the method of Bezredki (0.1 ml of diluted 100-fold antidiphtheria serum is injected strictly intradermally into the flexor surface of the forearm, a negative sample is injected subcutaneously with 0.1 ml of undiluted serum and in the absence of symptoms of anaphylactic shock after 30 min enter intramuscularly the rest of the dose). Doses of antidiphtheria serum depend on the form, severity, day of illness and, to some extent, the age of the patient. Only to children of the 1st and 2nd years of life, the dose is reduced by 1.5-2 times.
- With localized forms of diphtheria of the oropharynx, nose and larynx, serum is usually administered once in a dose of 10 000-30 000 AE, but if the effect is insufficient, the administration is repeated after 24 hours.
- With the widespread and subtoxic form of the oropharyngeal diphtheria, as well as with the widespread croup, the treatment with antidiphtheria serum continues for 2 days. Enter for 30 000-40 000 AE 1 time per day.
- With the toxic form of the oropharyngeal diphtheria of the 1st and 2nd degree, the average dose of antidiphtheria serum for the course of treatment is 200 000-250 000 AE. In the first two days the patient must enter 3/4 of the course dose. In the first day, the serum is administered 2 times with an interval of 12 hours.
- With toxic III degree and hypertoxic, as well as with combined form, the course dose can be increased to 450,000 AE. In the first day, half the course dose is administered in 3 divided doses at an interval of 8 hours. One-third of the daily dose can be administered intravenously. The introduction of serum is stopped after the disappearance of fibrinous plaques. Simultaneously with the serum prescribe antibiotics (macrolides or cephalosporins) in conventional doses inside, intramuscularly or intravenously for 5-7 days.
Treatment of bacterial carriers
First of all it is necessary to carry out general restorative therapy and sanation of chronic foci of the nasopharynx. Assign vitamins, provide adequate nutrition, walks. With prolonged carriage, give erythromycin or other macrolides inside for 7 days. More than 2 courses of antibiotic therapy should not be conducted.