Journal Article

Penicillin vs. Erythromycin in the Treatment of Diphtheria

Rachel Kneen, Pham Ngoc Giao, Tom Solomon, Tran Thi My Van, Nguyen Thi Tuyet Hoa, Tran Buu Long, John Wain, Nicholas P. J. Day, Tran Tinh Hien, Christopher M. Parry and Nicholas J. White

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 4, pages 845-850
Published in print October 1998 | ISSN: 1058-4838
Published online October 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/514959
Penicillin vs. Erythromycin in the Treatment of Diphtheria

More Like This

Show all results sharing these subjects:

  • Infectious Diseases
  • Immunology
  • Public Health and Epidemiology
  • Microbiology

GO

Show Summary Details

Preview

In an open-label, randomized trial, 44 Vietnamese children with diphtheria were given penicillin therapy (intramuscular benzylpenicillin, 50,000 U/[kg·d] for 5 days and then oral penicillin, 50 mg/ [kg·d] for 5 days), and 42 were given erythromycin therapy (50 mg/[kg·d] orally for 10 days). There were no differences in times to membrane clearance or bacteriologic clearance, but median times to fever clearance were 27 hours (95% confidence interval [CI], 19–30; range, 0–124 hours) for penicillin recipients and 46 hours (95% CI, 34–54; range, 0–148 hours) for erythromycin recipients (P = .0004). In the penicillin group, acute treatment failed for one patient, and one patient relapsed. Three patients in the penicillin group developed diphtheritic myocarditis as evidenced by abnormal electrocardiograms. Erythromycin did not cause prolongation of the QT interval corrected for heart rate. Cultures of specimens from 15 patients (17.4%) were positive for toxigenic Corynebacterium diphtheriae. All isolates were susceptible to penicillin, but four isolates (27%), all of which were from patients who received penicillin treatment, were resistant to erythromycin (minimum inhibitory concentrations, >64 mg/L). Penicillin is recommended as first-line treatment for diphtheria in Vietnam.

Journal Article.  0 words. 

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.