Diphtheria — Uganda (General Adult population)
Antitoxin (HC4)
Diphtheria Antitoxin (DAT) 20,000–100,000 IU IV depending on severity and duration of illness. Give as soon as diagnosis is suspected — do not wait for culture results. Test for hypersensitivity before use.
Antibiotics — Initial (HC4)
Benzylpenicillin 600,000 IU IM 12-hourly until patient can swallow. Child: Procaine benzylpenicillin 50,000 IU/kg per day IM once daily until patient can swallow.
Antibiotics — When Able to Swallow
Penicillin V 250 mg every 6 hours to complete 14 days total. Child 1–6 years: 125 mg 6-hourly. Child <1 year: 12.5 mg/kg every 6 hours.
Penicillin Allergy
Erythromycin 500 mg every 6 hours for 14 days. Child: 50 mg/kg every 6 hours.
Isolation & Contact Management
Isolate patient. Monitor close contacts for 7 days. Prophylactic antibiotics for contacts: Single dose Benzathine Penicillin IM (child <10 years: 600,000 IU; child >10 years and adults: 1.2 MIU). Verify immunisation status of contacts and complete or boost if needed.
Prevention
Immunise all children during routine childhood immunisation (DPT schedule).
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