Diphtheria: Drug Therapy

Therapeutic targets

  • Elimination of the pathogens
  • Avoidance of complications

Therapy recommendations

  • Antibiosis (antibiotics) in combination with diphtheria antitoxin.
  • Postexposure prophylaxis (PEP) [see below].
  • See also under “Further therapy“.

Antibiotics Antibiotics are drugs that are administered when an infection with a bacterium is present. They act either bacteriostatic, by inhibiting the growth of bacteria, or bactericidal, that is, they kill the bacteria. Important representatives of this group of drugs are penicillin or cephalosporins. In diphtheria, antibiotics from the penicillin or erythromycin groups are mainly used.

Antitoxin In addition to immediately initiated antibiotic therapy, the administration of antitoxin must also be rapid in order to bind the remaining unbound toxin of the bacterium. Currently, only equine antitoxin is available for this purpose.

Postexposure prophylaxis (PEP)

Postexposure prophylaxis is the provision of medication to prevent disease in persons who are not protected against a particular disease by vaccination but have been exposed to it.

Indications (areas of application)

  • Persons with close (“face to face”) contact with a sick person.
  • Epidemics or regionally increased morbidity (disease incidence).

Implementation

  • In persons with close (“face to face”) contact with a diseased person:
    • Chemoprophylaxis – regardless of vaccination status, preventive (prophylactic) antibiotic therapy: penicillin or erythromycin seven to ten days.
    • Postexposure vaccination, if the last vaccination 5 years ago.
  • At the first appearance of symptoms of diphtheria, diphtheria antitoxin is administered immediately.
  • In epidemics or regionally increased morbidity.
    • Vaccination according to the recommendations of the health authorities