Diphtheria antitoxin


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Nasal diphtheria 10,000-20,000 u via infusion. Tonsillar diphtheria 15,000-25,000 u via infusion. Pharyngeal or laryngeal diphtheria 20,000-40,000 u via infusion. Cutaneous diphtheria 20,000-40,000 u via infusion to be used only if ulcer >2 cm2. Severe diphtheria Up to 10,000 u via infusion. SC Desensitisation of diphtheria hypersensitivity Equine diphtheria antitoxin is administered in incremental doses every 15 mins: 0.05 mL of a 1:20 dilution, 0.1 mL of 1:10 dilution, 0.3 mL of a 1:10 dilution and 0.1 mL of undiluted antitoxin. After another 15 minutes, 0.5 mL of undiluted antitoxin is administered IM or IV. Subconjunctival Diphtheria hypersensitivity test 1 drop of a 1:10 dilution of equine diphtheria antitoxin is placed in the lower conjunctival sac of one eye. Topical Scratch test for diphtheria hypersensititvity 1 drop of 1:100 diluion of equine diphtheria antitoxin is placed on the skin and a 0.64 cm scratch is made through the drop. Intradermal Diphtheria hypersensitivity test 0.1 mL of equine diphtheria antitoxin in normal saline at 1:100 dilution. For patient w/ a history of allergy: 0.05 mL of a 1:1,000 dilution.
Dosage Details
Intradermal
Diphtheria hypersensitivity test
Adult: 0.1 ml of diphtheria antitoxin (equine) in 0.9% sodium chloride in a 1:100 dilution. Skin test read 20 minutes later. If patient has a history of allergy: 0.05 ml of a 1:1000 dilution. An inj of 0.9% sodium chloride can be used as a control. A positive reaction is represented by an urticarial wheal, with or without pseudopods, with a zone of erythema.

Intravenous
Mild to moderate nasal diphtheria
Adult: 10 000-20 000 units via slow IV infusion.

Intravenous
Mild to moderate tonsillar diphtheria
Adult: 15 000-25 000 units via slow IV infusion.

Intravenous
Mild to moderate pharyngeal or laryngeal diphtheria
Adult: 20 000-40 000 units via slow IV infusion.

Intravenous
Severe diphtheria
Adult: Up to 100 000 units by slow IV infusion.

Intravenous
Mild to moderate cutaneous diphtheria
Adult: Only used if ulcer >2 cm2 (insufficiently absorbed in smaller ulcers). Dose: 20 000-40 000 units by slow IV infusion.

Subconjunctival
Diphtheria hypersensitivity test
Adult: 1 drop of a 1:10 dilution of equine diphtheria antitoxin administered to lower conjunctival sac of 1 eye, control test of 0.9% sodium chloride administered to other eye. Test read after 15 minutes. A positive test is represented by ocular itching, burning, redness and lacrimation which can be relieved by applying 1 drop of ocular epinephrine solution on the affected eye.

Subcutaneous
Desensitisation of diphtheria hypersensitivity
Adult: Diphtheria antitoxin (equine) is administered in incremental doses every 15 minutes: 0.05 ml of a 1:20 dilution, 0.1 ml of 1:10 dilution, 0.3 ml of a 1:10 dilution and 0.1 ml of undiluted antitoxin. After another 15 minutes, 0.5 ml of undiluted antitoxin is administered IM or IV.

Topical/Cutaneous
Scratch skin test for diphtheria hypersensitivity
Adult: 1 drop of a 1:100 dilution of equine diphtheria antitoxin placed on the skin and then a 0.64 cm scratch made through the drop. A control of 0.9% sodium chloride can be used. Test read after 20 minutes. A positive reaction is represented by an urticarial wheal, with or without pseudopods, with a zone of erythema.
Contraindications
Hypersensitivity.
Special Precautions
History of asthma. Test doses should be administered before immunisation to eliminate hypersensitivity. Adrenaline inj and resuscitation facilities should be available after all immunisation. Not used for diphtheria prophylaxis because of hypersensitivity risk. A negative sensitivity test dose so not completely exclude systemic sensitivity. If hypersensitivity occurs during or immediately after desensitisation procedure, a tourniquet should be applied and adrenaline administered next to the site of inj.
Adverse Reactions
Serum sickness (type III hypersensitivity reaction) up to 12 days after antitoxin admin, symptoms include: Urticaria, fever, pruritus, malaise, skin rash and arthralgia. Accelerated serum sickness (occurring <7 days after immunisation) may occur in individuals with previous admin of equine serum.
Potentially Fatal: Anaphylactic reactions (type I hypersensitivity reaction): Sudden onset of urticaria, respiratory distress, hypotension, shock and vascular collapse.
Action
Description: Diptherias antitoxin is used, often concurrently with an antibiotic, for passive immunisation against suspected diphtheria infection. It contains specific globulins which negate the local and systemic effects of toxins produced by Corynebacterium diptheriae.
Storage
Store at 2-8 °C, do not freeze.
Disclaimer: This information is independently developed by MIMS based on Diphtheria antitoxin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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