Ophthalmologic Manifestations of Diphtheria Medication

Updated: Feb 18, 2019
  • Author: Andrew A Dahl, MD, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Medication

Medication Summary

Treatment includes supportive care and isolation, as well as penicillin or erythromycin, which are extremely effective against C diphtheriae.

Diphtheria antitoxin, a hyperimmune antiserum produced in horses, protects against neurotoxicity when given within the first or second day of illness. Prevention is accomplished by immunization with formalin-inactivated toxin, usually given within first year of life.

Additional treatment of primary ocular infection includes topical erythromycin ointment, frequent manual removal of infected membranes, and ocular lubrication. Topical steroids may be used to reduce inflammation if no corneal ulceration is present.

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Antibiotics

Class Summary

Empiric antimicrobial therapy must be comprehensive and should cover all likely pathogens in the context of the clinical setting.

Penicillin G benzathine (Bicillin LA)

Interferes with synthesis of cell wall mucopeptides during active multiplication, which results in bactericidal activity. Effective treatment for systemic diphtheria.

Erythromycin

Inhibits bacterial growth, possibly by blocking dissociation of peptidyl t-RNA from ribosomes causing RNA-dependent protein synthesis to arrest.

In children, age, weight, and severity of infection determine proper dosage. When bid dosing is desired, half-total daily dose may be taken q12h. For more severe infections, double the dose. Effective treatment for systemic diphtheria

Erythromycin ophthalmic (E-Mycin)

Indicated for infections caused by susceptible strains of microorganisms and for prevention of corneal and conjunctival infections. For local control of diphtheric involvement of eye

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Corticosteroids

Class Summary

Have anti-inflammatory properties and cause profound and varied metabolic effects.

Prednisolone acetate 1% ophthalmic drops (Pred Forte)

Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing increased capillary permeability. To be used to minimize membrane formation and scarring. To reduce inflammation in the eye(s)

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