In order to identify contraindications, the doctor on the day of drug administration surveys and examines the patient with obligatory thermometry and the setting of an intradermal test with immunoglobulin, an antisibiric horse, diluted 1: 100, to determine the sensitivity of the patient to the proteins of the horse's serum. To this end, 0.1 ml of diluted 1: 100 immunoglobulin (the ampoule is marked in red color) is injected intradermally into the area of the flexor surface of the forearm. The reaction is taken into account after 20 minutes.
The sample is considered negative if the diameter of the papule does not exceed 0.9 cm, and the redness around it is limited. With a negative intracutaneous sample, 0.1 ml of the undiluted immunoglobulin of the antisibiric horse (the ampoule is marked in blue) is injected subcutaneously into the region of the middle third of the shoulder. In the absence of a local or general reaction after 30 minutes, intramuscularly injected into the upper outer quadrant of the buttocks fractional 2-3 times with an interval of 10-15 minutes the entire prescribed dose of the drug, after which the vaccine should be under the supervision of the doctor for one hour.
With a positive intradermal test, as well as in cases of anaphylactic reaction to subcutaneous injection,Immunoglobulin, an antisibirica, a horse, a solution for intramuscular injection, is administered to patients only according to vital indications under the supervision of a physician, with special precautions and only after preliminary intravenous administration of 90-120 mg of prednisolone. It is recommended that the immunoglobulin protivosibirichevenny horse be injected under the skin first, diluted 1: 100, used for intradermal test, with an interval of 20 minutes in doses of 0.5 ml, 2 ml, 5 ml. In the absence of reaction to these doses, 0.1 ml of undiluted preparation is injected subcutaneously into the middle third of the shoulder region, in the absence of local or general reaction, after 30 minutes all the prescribed amount of the drug is fractionally administered.
The drug is not administered to patients with a positive intradermal test in the absence of life indications. In cases of extremely severe form of the disease course and with sepsis, the immunoglobulin is injected into different sites in the amount of 75-100 ml without determining the sensitivity and with intravenous administration of 90-120 mg of prednisolone. With the development of an anaphylactic reaction, it is necessary to carry out anti-shock measures.
The drug should be injected strictly aseptically intramuscularly into the gluteal region in a warmed to a temperature of 36-37 ° C.
For the purpose of emergency prevention immunoglobulin antiviral administered once: adults - 20-25 ml, children, depending on the age - 5-8 ml, adolescents from 14 to 17 years - 12 ml. The use of immunoglobulin for preventive purposes is not recommended in cases where it took more than 5 days after eating the meat of a sick animal or after possible infection of the skin.
With the therapeutic purpose, the drug is administered immediately to establish the diagnosis of anthrax in combination with other methods of treatment (antibiotics, etc.) every day 30-50 ml for the moderate and severe course of the disease, and for extremely severe and sepsis 75-100 ml during the first 3-4 days of illness. With mild disease, administer the drug is not recommended.
In order to better absorb immunoglobulin in one place should be administered no more than 50 ml of the drug.