Infection control

Diphtheria is spread by droplet infection from the respiratory tract, by close contact with respiratory tract secretions, or with exudate from cutaneous lesions. Patients with this condition should be isolated. At least 5 days after antibiotic therapy has been completed, throat and nose cultures should be taken 24 to 48 h apart. The patient should remain in isolation until three consecutive cultures have been reported negative. Close contacts who are incompletely immunized, or in whom the immunization status is unclear, should be vaccinated against diphtheria. They should also receive prophylactic antibiotic therapy (usually erythromycin) pending the results of their throat swab cultures.

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