People with tetanus need to be in an intensive care unit so they can receive treatment and continuous monitoring.
Treatment of tetanus usually includes:
- supportive care
- medications to control muscle spasms
- antibiotics and tetanus immune globulin to manage the infection
- wound treatment
Supportive care: The biggest threat is to breathing. People who get tetanus usually have mechanically assisted ventilation through a breathing tube. This may involve a tracheostomy, which is a tube inserted directly through a hole cut in the throat.
Because people with tetanus may not be able to swallow, they are usually given nourishment either intravenously or through a nasogastric (NG) tube, which is inserted through the nose, past the throat, and into the stomach. A catheter (tube) may also be inserted in the bladder to drain it.
Medications to control muscle spasms: Medications such as benzodiazepines (e.g., midazolam, diazepam), dantrolene, or baclofen are given to reduce muscle spasms*.
Antibiotics and tetanus immune globulin: As the consequences of tetanus are due to a toxin produced by the bacteria, an injection of antitoxin is given to the patient. This antitoxin is an antibody preparation that will bind any remaining toxin and prevent it from binding to the nerve cells. They may also need tetanus immune globulin (a blood product from an immune person).
Antibiotics (e.g., metronidazole, penicillin) are used to kill the tetanus bacteria, the source of the toxin, but they are too slow-acting to be the only treatment. If there is an open wound where the tetanus bacteria are thriving, then that wound is surgically cleaned to physically remove any tetanus bacteria.
Vaccination: In people who develop tetanus, the amount of bacteria causing the disease is too small to lead to an effective immune response. This means that these people could get tetanus again. All people who have had tetanus should also receive a tetanus vaccination as part of treatment.
Tetanus is a preventable disease, thanks to the development of a vaccine. When you see a doctor for a cut that might be dirty or infected, the preventive treatment you get depends on your vaccination status. The tetanus vaccine provides good protection for 5 years. Its effectiveness then slowly tails off.
For clean, minor wounds, people who have been vaccinated in the last 10 years don't need any treatment. People who were vaccinated more than 10 years ago get a booster shot of the vaccine, which consists of a weakened form of the tetanus toxin. For deep or dirty wounds, people who received their last tetanus booster more than 5 years ago will need another booster shot.
Those who have never been vaccinated, or have an uncertain vaccination history, need tetanus immune globulin. They also need to be vaccinated against tetanus. People with deep, dirty wounds who have a suppressed immune system (e.g., people with HIV or other immune system problems) will be given tetanus immune globulin.
Children today are normally vaccinated at 2, 4, and 6 months, then again at 18 months and once more around age 4 to 6. Most children will receive a vaccine that protects against tetanus, diphtheria, pertussis, polio, and Hib (Haemophilus influenzae type b) for the doses given at 2, 4, 6, and 18 months of age. A vaccine that protects against tetanus, diphtheria, pertussis (whooping cough), and polio is usually given at 4 to 6 years of age. A further shot, with the adult diphtheria-tetanus-pertussis vaccine, is recommended around age 14 to 16. Adults should continue to get booster shots every 10 years to minimize the risk of tetanus.
Other vaccination schedules may be used for adults or children over 7 years of age who have not been previously vaccinated. Talk to your health care provider for more information.
You can also reduce your risk of tetanus by cleaning all wounds thoroughly, rinsing them with clean water and washing the area around the wound with soap and water. If the wound is deep and dirty, see your doctor.
You might consider wearing knee and elbow pads during sports that are likely to involve violent contact with the ground. Avoid going barefoot while outside of your house. This will help to prevent infection from accidentally stepping on sharp, dirty objects.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2017. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Tetanus