Treatment

Although antitoxin remains the only specific method treatment of diphtheria,

antibiotics are administered to patients with disease and to asymptomatic carriers of
toxigenic strains. C. diphtheria is usually inhibited by penicillins and macrolides. The
antimicrobial susceptibilities of other species of corynebacteria or diphtheroids are far less
predictable. Treatment of infection caused by these organisms is often complicated by the
presence of compromised host defenses and implanted prosthetic materials (henry 2016).
The empirical choices of antibiotics are macrolides (erythromycin, azithromycin or
clarithromycin) or benzylpenicillin, all of which are usually active
against C. diphtheriae and C. ulcerans (49). If erythromycin cannot be tolerated (because of
gastrointestinal side-effects) an alternative macrolide such as azithromycin or clarithromycin
should be given. Parental benzylpenicillin or erythromycin should be used until the patient
can swallow comfortably, then erythromycin or penicillin V should be continued. Christine C.
Chiou, M.D.