Abstract NEONATAL TETANUS is a highly lethal disease. A very high fatality rate varying from 71.2% to 91% has been reported by various workers.1-11 Administration of antitetanic serum (ATS) has been one of the mainstays of treatment. But, the attempts of early workers to reduce the mortality by increasing the dose of ATS12-18 have not been successful. Indeed, the value of high doses of ATS has been doubted by some workers.19,20 Bryant and Fairman19 even suggested that ATS was not at all necessary for the treatment of tetanus and could be dispensed with entirely. Others who were more conservative held the opinion that usual doses of ATS could be substantially reduced without any detrimental effect.9,21-26 As long ago as 1930, Hines27 stated that ATS had not proved to be of great value and suggested that a dosage of 10,000 to 20,000 units should be adequate References 1. Athavale, V.B., and Pai, P.N.: "Tetanus Neonatorum: Clinical Manifestations," in the Proceedings of the First International Conference on Tetanus, Study Group of Tetanus, Bombay, 1965. 2. Howard, H.F., and DeVere, W.: Intramuscular Meprobamate in the Treatment of Tetanus in Infants and Children , J Pediat 60:421, 1962.Crossref 3. Jellife, D.B.: Tetanus Neonatorum , Arch Dis Child 25:190, 1950.Crossref 4. Loh Siew Gek, cited by Tompkins, A.B.: Neonatal Tetanus in Nigeria , Brit Med J 1:1382, 1958.Crossref 5. Mathur, H.N., and Singh, R.N.: "Tetanus: A Clinical Study," in the Proceedings of the First International Conference on Tetanus, Study Group of Tetanus, Bombay, 1965. 6. Patel, J.C., et al: Tetanus Neonatorum , Indian J Child Health 9:459, 1960. 7. Paul, S.S.; Gupta, S.; and Singh, R.N.: An Analysis of Tetanus in Children Treated Without ATS and Comparison With Other Methods of Treatment: A Report of 599 Cases , Indian Pediat 1:319, 1964. 8. Pinheiro, D.: Tetanus of the Newborn Infant: A Review of 238 Cases Treated in the Hospital das Clinicas , Sao Paulo, Brazil, Pediatrics 34:32, 1964. 9. Tompkins, A.B.: Neonatal Tetanus in Nigeria , Brit Med J 1:1382, 1958.Crossref 10. Vaishnava, H., et al: Clinical Study of Tetanus in Delhi for a Period of 32 Months , J Assoc Physicians India 12:691, 1964. 11. Vakil, B.J., et al: "A Study of 2130 Cases of Tetanus With Special Reference to Incidence, Clinical Types, and Prognosis," in the Proceedings of the First International Conference on Tetanus, Study Group of Tetanus, Bombay, 1965. 12. Cole, L.: Treatment and Prognosis of Tetanus , Proc Roy Soc Med 31:1205, 1938. 13. Cole, L., and Spooner, E.T.: The Treatment of Tetanus With Observations on the Rate of Injected Antitoxin , Quart J Med 4:295, 1935. 14. Khosla, H.L., and Bhatt, A.N.: A Study of Tetanus in the Medical College Hospital , J Indian Med Assoc 22:52, 1952. 15. Verner, H.I., and Brewer, A.G.: Clinical Tetanus , JAMA 116:1627, 1941.Crossref 16. Vinnard, R.T.: Three Hundred and Fifty-Two Cases of Tetanus , Surgery 18:482, 1945. 17. Yodh, B.B.: Observations on the Treatment of Tetanus , Brit Med J 2:589, 1932.Crossref 18. Yodh, B.B.: Further Observations on the Treatment of Tetanus , Brit Med J 1:855, 1937.Crossref 19. Bryant, I., and Fairman, H.D.: Treatment of Tetanus With Sodium Evipan and MB 693 , Lancet 2:263, 1940.Crossref 20. Johnstone, D.D.: Tetanus in Nigeria: Review of 100 Cases Treated in Ibadan , Brit Med J 1:12, 1958.Crossref 21. Patel, J.C., et al: Dosage of Antitetanus Serum in the Treatment of Tetanus , Indian J Med Sci 14:855, 1960. 22. Patel, J.C., et al: Serum Therapy in Tetanus , Lancet 1:740, 1963.Crossref 23. Patel, J.C.; Mehta, B.C.; and Goodluck, P.L.: "Tetanus: Experience With 4,718 Cases," in the Proceedings of the First International Conference on Tetanus, Study Group of Tetanus, Bombay, 1965. 24. Sahiar, N.K.: Some Observations on Tetanus , Indian Physician 3:120, 1944. 25. Spaeth, R.: Serum Therapy of Tetanus , Amer J Dis Child 61:1146, 1941.Crossref 26. Veronesi, R.: Clinical Observations on 712 Cases of Tetanus Subjected to Four Different Methods of Treatment , Amer J Med Sci 232:629, 1956.Crossref 27. Hines, E.A., Jr.: Tetanus Neonatorum , Amer J Dis Child 39:560, 1930.Crossref 28. Athavale, V.B., and Pai, P.N.: Role of Tetanus Antitoxin in the Treatment of Tetanus in Children , J Pediat 68:289, 1966.Crossref 29. Patel, J.C., and Joag, G.G.: Grading of Tetanus to Evaluate Prognosis , Indian J Med Sci 13:834, 1959. 30. Patel, J.C.: Antitetanus Serum in the Treatment of Tetanus: Comparison of Two Dosage Schedules by Matched Pair Sequential Analysis , Indian J Med Sci 18:697, 1964.
American Journal of Diseases of Children – American Medical Association
Published: Aug 1, 1967