A single dose of serum is: for localized forms 10000-20000 ME, diphtheria of the larynx 40000 - 50000 ME, with a subtotal form of 40000-50000 ME, toxic I degree 50000-70000 ME, toxic II degree 60000-80000 ME, hemorrhagic 100000-120000 ME.
If there is no effect, serum administration can be repeated after 12-24 hours using the same doses.
Serum is administered intramuscularly and subcutaneously. As a rule, the maximum volume of a drug administered in one place should not exceed 10 ml.
Before the first introduction of serum without fail put cutaneous test with an equine serum diluted 1: 100 serum (ampoule marked in red) to determine the patient's sensitivity to horse serum proteins. Serum horse purified diluted 1: 100 is injected in a volume of 0.1 ml intradermally into 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 edema and (or) redness appearing at the injection site is less than 1 cm. The sample is considered positive if the edema and / or redness reaches a diameter of 1 cm or more.
With a negative skin test, serum antidiphtheria (ampoule marked in blue or black color) is administered in a volume of 0.1 ml subcutaneously to the area of the middle third of the shoulder.
In the absence of a local or general reaction via (45±15) min is administered intramuscularly to the area of the upper third of the anterior-external surface of the thigh or buttock the appointed dose of serum antidiphtheria, heated to a temperature of (36 ± 1) ° C. The patient who received the serum should be under the supervision of the doctor for an hour.
With a positive intradermal test, the serum is administered only according to vital indications under the supervision of a physician and with special precautions. Initially, injected serum under the skin serum antidiphtheria diluted in doses of 0.5 ml, 2 ml, 5 ml (diluted serum is prepared immediately before use, introducing 0.1 ml of serum antidiphtheria in 9.9 ml sterile sodium chloride solution 0.9%) at intervals 20 minutes. In the absence of a reaction to these doses, 0.1 ml of serum is administered subcutaneously with antidiphtheria. In the absence of reaction, after 30 minutes, all the prescribed amount of serum is administered intramuscularly. In the case of a positive reaction to one of the above doses,serum antidiphtheria is not injected or injected under anesthesia, having a syringe ready with a 0.1% solution of epinephrine hydrochloride or a 0.2% solution of noradrenaline hydrotartrate.
All manipulations are carried out by separate sterile syringes, the opened ampoule is closed with a sterile napkin, stored at a temperature (20 ± 2) ° C not more than 1 hour.
An uncovered ampoule with an equine serum diluted 1: 100 is not subject to storage.