If a membrane is present, samples should be taken from the membrane or beneath its edge. Management of cases Patients with suspected respiratory diphtheria should be treated on clinical grounds. Therapy should not be delayed until bacteriologic confirmation is obtained . Antitoxin therapy is considered the mainstay of treatment while antibiotic therapy is required to eradicate the organism and prevent spread. Diphtheria antitoxin Prompt administration of antitoxin is essential as the antitoxin will only neutralize circulating toxin that is not yet bound to tissue.
Delayed administration increases the risk of late effects such as myocarditis and neuritis.
A single dose of' diphtheria antitoxin should be administered even before culture results are available. Antitoxin dosage depends on the site and extent of the diphtheritic membrane, the degree of toxicity, and the duration of illness. Consult product monographs for additional specifications. As diphtheria antitoxin is of equine origin, all patients should be tested for sensitivity to horse serum before administration of antitoxin, and if necessary desensitized. Therefore, all efforts should be made to obtain sufficient antitoxin before treatment is started.