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htheria
– A ntibiotic treatm ent:
benzathine benzylpenicillin IM
C h ild ren und er 6 years: 6 0 0 0 0 0 IU as a sing le d ose
C h ild ren ov er 6 years and ad ults: 1 .2 M IU as a sing le d ose
or
procaine benzylpenicillin I M
C h ild ren: 5 0 0 0 0 I U / kg once d aily for 7 d ays
A d ults: 1 .2 M IU once d aily for 7 d ays
F or penicillin-allerg ic patients:
erythromycin P O
C h ild ren: 5 0 m g / kg / d ay in 2 to 3 d iv id ed d oses for 7 d ays
A d ults: 2 to 3 g / d ay in 2 to 3 d iv id ed d oses for 7 d ays
– U rg ent interv ention to secure an airw ay (intubation, trach eotom y) m ay be necessary
in th e ev ent of laryng eal obstruction or card iac or neurolog ic com plications.
Management of close contacts
– N ose and th roat cultures.
– D aily clinical m onitoring (th roat exam ination and tem perature) for 7 d ays.
– Q uarantine
– A ntibiotic treatm ent: see abov e.
– V erify v accination status:
• less th an 3 injections: com plete w ith D T P , D T or T d d epend ing on ag e,
• 3 injections: if th e last injection w as g iv en m ore th an one year before, g iv e a booster
d ose.
T h e sam e precautions sh ould be taken for contacts of h ealth y carriers.
Prevention
T h ere are 3 com bined v accines:
D T P : d iph th eria-tetanus-pertussis
D T : d iph th eria (3 0 IU ) and tetanus, for th ose und er 7 years of ag e
T d : d iph th eria (3 IU ) and tetanus, for th ose ov er 7 years of ag e
– In th e ev ent of an epid em ic, m ass v accination:
U pd ate routine v accinations w ith D T P for ch ild ren und er 3 years of ag e; D T for
ch ild ren from 3 to 6 years of ag e; T d for ch ild ren ov er 7 years of ag e and ad ults.
– R outine v accination (E P I). T h e recom m end ations v ary accord ing to th e country. F or
inform ation:
D T P : 3 d oses at one m onth interv als before th e ag e of 1 year, D T P booster one year
later, and D T at 6 years of ag e follow ed by 3 m ore boosters at 1 0 year interv als.
Note: th e d isease d oes not g iv e im m unity. U pd ate th e v accination of th e patients once
th ey h av e recov ered . V accination d oes not prev ent ind iv id uals from becom ing carriers.
56
– A ntibiotic treatm ent:
benzathine benzylpenicillin IM
C h ild ren und er 6 years: 6 0 0 0 0 0 IU as a sing le d ose
C h ild ren ov er 6 years and ad ults: 1 .2 M IU as a sing le d ose
or
procaine benzylpenicillin I M
C h ild ren: 5 0 0 0 0 I U / kg once d aily for 7 d ays
A d ults: 1 .2 M IU once d aily for 7 d ays
F or penicillin-allerg ic patients:
erythromycin P O
C h ild ren: 5 0 m g / kg / d ay in 2 to 3 d iv id ed d oses for 7 d ays
A d ults: 2 to 3 g / d ay in 2 to 3 d iv id ed d oses for 7 d ays
– U rg ent interv ention to secure an airw ay (intubation, trach eotom y) m ay be necessary
in th e ev ent of laryng eal obstruction or card iac or neurolog ic com plications.
Management of close contacts
– N ose and th roat cultures.
– D aily clinical m onitoring (th roat exam ination and tem perature) for 7 d ays.
– Q uarantine
– A ntibiotic treatm ent: see abov e.
– V erify v accination status:
• less th an 3 injections: com plete w ith D T P , D T or T d d epend ing on ag e,
• 3 injections: if th e last injection w as g iv en m ore th an one year before, g iv e a booster
d ose.
T h e sam e precautions sh ould be taken for contacts of h ealth y carriers.
Prevention
T h ere are 3 com bined v accines:
D T P : d iph th eria-tetanus-pertussis
D T : d iph th eria (3 0 IU ) and tetanus, for th ose und er 7 years of ag e
T d : d iph th eria (3 IU ) and tetanus, for th ose ov er 7 years of ag e
– In th e ev ent of an epid em ic, m ass v accination:
U pd ate routine v accinations w ith D T P for ch ild ren und er 3 years of ag e; D T for
ch ild ren from 3 to 6 years of ag e; T d for ch ild ren ov er 7 years of ag e and ad ults.
– R outine v accination (E P I). T h e recom m end ations v ary accord ing to th e country. F or
inform ation:
D T P : 3 d oses at one m onth interv als before th e ag e of 1 year, D T P booster one year
later, and D T at 6 years of ag e follow ed by 3 m ore boosters at 1 0 year interv als.
Note: th e d isease d oes not g iv e im m unity. U pd ate th e v accination of th e patients once
th ey h av e recov ered . V accination d oes not prev ent ind iv id uals from becom ing carriers.
56
