DIPHTERIA ANTITOXIN, equine purif., 10.000IU/10ml, vial+dil.
Valid Article
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DIPHTERIA ANTITOXIN, equine purified - NST
With the increased use of the vaccine and the decline in the incidence of the disease, the supply of DAT has become increasingly complex. Most countries no longer produce the serum, and obtaining stocks and controlling quality is concern worldwide. It has been unavailable in many countries, including in Europe, since 2008.
Full Name
Diphtheria Anti-Toxin (DAT)
Therapeutic Action
Enzyme refined equine immunoglobulins.
Diphtheria antitoxin neutralises the free-circulating toxin before it can irreversibly bind to tissues and cause organ damage. Its effectiveness therefore decreases with the time elapsed since the onset of symptoms.
Indications
Treatment of diphtheria during an outbreak in patients meeting the diphtheria "suspect case" definition, including pregnant and lactating women, in combination with antibiotic treatment.
Not recommended for the prevention of diphtheria, as the protective effect of diphtheria antitoxin lasts only 1 to 2 weeks.
Instructions for use
Each vial contains 10,0000 IU equivalent to 1,000IU/ml.
Two presentations are available:
- liquid vial (DVACADIP1V-)
- powder vial (DVACADIP1VD) to be reconstituted with the diluent supplied.
Must be given by IV infusion in 0.9% NaCl, as early as possible, as a single dose.
Dosage does not depend on the weight or age, but on clinical presentation.
Given the risk of allergic reactions, administer systematically antihistamines and corticoids as premedication.
Administer IV/PO antibiotics (azithromycin or erythromycin) in combination with diphtheria antitoxin to eliminate bacteria and toxin production, prevent further transmission and limit carriage, which may persist even after clinical recovery.
Treatment should be accompanied by isolation precautions.
After recovery, complete vaccination (tetanus-diphtheria vaccine).
Monitor close contacts for signs and symptoms for 10 days from the date of last contact with a suspected case. Antibiotic prophylaxis should be administered to close contacts for seven days.
Precautions for Use
As DAT is from equine origin, there is a risk of:
- rare but severe anaphylactic reaction and frequent risk of mild reaction. DAT must be administered under close medical monitoring, in hospital settings equipped with ventilation and resuscitation equipment, Ringer lactate and epinephrine.
- serum sickness weeks after administration. Ensure clinical follow-up.
Divided doses are not recommended as this increases risk of sensitivity reactions (see section on side effects). If in exceptional circumstances, the full dose cannot be given in a single administration, (e.g., in a small child), the maximum interval between the 2 split doses should not exceed 24 hours.
Storage
- Liquid vial (DVACADIP1V-): keep refrigerated between 2ºC and 8ºC - Protect from sunlight
- Powder vial (DVACADIP1VD): below 25ºC (does not require cold chain)
- Do not freeze.
Description updated and validated by Spinco and Vaccination WG on 28/02/2024.
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