Editing Diphtheria (section)

==Treatment==
The disease may remain manageable, but in more severe cases, [[lymph nodes]] in the neck may swell, and breathing and swallowing are more difficult. People in this stage should seek immediate medical attention, as obstruction in the throat may require [[intubation]] or a [[tracheotomy]]. Abnormal cardiac rhythms can occur early in the course of the illness or weeks later, and can lead to [[heart failure]]. Diphtheria can also cause paralysis in the eye, neck, throat, or respiratory muscles. Patients with severe cases are put in a hospital [[intensive care unit]], and given diphtheria [[antitoxin]] (consisting of [[antibodies]] isolated from the [[Serum (blood)|serum]] of horses that have been challenged with diphtheria toxin).<ref name=":1" /> Since antitoxin does not neutralize toxin that is already bound to tissues, delaying its administration increases risk of death. Therefore, the decision to administer diphtheria antitoxin is based on clinical diagnosis, and should not await laboratory confirmation.<ref name="Pinkbook">{{Cite book | vauthors = Atkinson W, Hamborsky J, McIntyre L, ((Wolfe S, eds.)) | chapter = Diphtheria | title = Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book) | edition = 10 | pages = 59–70 | location = Washington, D.C. | publisher = Public Health Foundation | year = 2007 | chapter-url = https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/dip.pdf | url-status = live | archive-url = https://web.archive.org/web/20070927000637/http://www.cdc.gov/vaccines/pubs/pinkbook/downloads/dip.pdf | archive-date = 27 September 2007 | df = dmy-all }}</ref>

Antibiotics have not been demonstrated to affect healing of local infection in diphtheria patients treated with antitoxin. Antibiotics are used in patients or carriers to eradicate ''C.&nbsp;diphtheriae,'' and prevent its transmission to others. The Centers for Disease Control and Prevention (CDC) recommends<ref>The first version of this article was adapted from the Centers for Disease Control and Prevention document [https://wwwn.cdc.gov/nndss/conditions/diphtheria/case-definition/1995/ "Diphtheria (''Corynebacterium diphtheriae'') 1995 Case Definition"] {{webarchive|url=https://web.archive.org/web/20161220041755/https://wwwn.cdc.gov/nndss/conditions/diphtheria/case-definition/1995/ |date=20 December 2016 }}. As a work of an agency of the U.S. government without any other copyright notice it should be available as a [[public domain resource]].</ref> either:
* [[Metronidazole]]
* [[Erythromycin]] is given (orally or by injection) for 14 days (40&nbsp;mg/kg per day with a maximum of 2''&nbsp;''g/d), or
* [[Procaine penicillin G]] is given intramuscularly for 14 days (300,000 U/d for patients weighing <10&nbsp;kg, and 600,000 U/d for those weighing >10&nbsp;kg); patients with allergies to penicillin G or erythromycin can use [[rifampin]] or [[clindamycin]].

In cases that progress beyond a throat infection, diphtheria toxin spreads through the blood, and can lead to potentially life-threatening complications that affect other organs, such as the heart and kidneys. Damage to the heart caused by the toxin affects the heart's ability to pump blood, or the kidneys' ability to clear wastes. It can also cause nerve damage, eventually leading to paralysis. About 40–50% of those left untreated can die.{{citation needed|date=June 2021}}<ref>{{Cite web |date=September 9, 2022 |title=Diagnosis, Treatment, and Complications |url=https://www.cdc.gov/diphtheria/about/diagnosis-treatment.html |access-date=March 7, 2023 |website=Centers for Disease Control and Prevention}}</ref>