Definition
Although rare in Italy, if contracted in the absence of a previous vaccination tetanus is a deadly disease: we are talking about an acute but not contagious bacterial infection involving the nervous system.
Causes
Tetanus is caused by the penetration of spores of the bacterium Clostridium tetani into the skin: the entry of the pathogen through the skin is favored by a wound resulting from the penetration of infected foreign bodies, such as nails or splinters.
Tetanus is an anaerobic pathogen localized in the digestive tract of herbivorous animals: it is released into the environment through the faeces of the same.
Symptoms
Tetanus generally begins with the involuntary and painful blockage of the jaw; associated with this are agitation, mood alteration, anxiety, painful convulsions, difficulty swallowing foods and liquids, excruciating pain, fever, hypertension, perception of cold, musculoskeletal stiffness and abundant sweating. Death occurs due to respiratory muscle paralysis associated or not with cardiac complications.
Information on Tetanus - Drugs for the Treatment of Tetanus is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Tetanus - Tetanus Drugs.
drugs
Given the high danger of tetanus, vaccination is mandatory in our country; an unvaccinated person who contracts tetanus must be immediately admitted to intensive care centers. Furthermore, the timely administration of specific anti-tetanus immunoglobulins reduces the risk of death. In the case of deep lesions at risk of tetanus, prophylaxis with antibiotics is necessary (for example with amoxicillin / benzylpenicillin combined with clavulanic acid / metronidazole / tinidazole). The administration of anticonvulsant and relaxing drugs of skeletal muscles is also indicated to lighten the symptoms.
In case of a deep wound ideally infected by the tetanus beating, an accurate cleaning of the lesion is necessary before starting the drug treatment.
Tetanus immunoglobulins of human origin: they are indicated for the treatment of wounds potentially at risk of tetanus. They are useful for "reversing" the poison: immunoglobulins are administered by deep intramuscular injection. Consult your doctor.
Antibiotics : these drugs must be associated with the administration of specific immunoglobulins. Below is the list of the most widely used antibiotics in therapy: it is then up to the doctor to indicate the dosage and method of use, based on the severity of the disease and the response to treatment.
- Penicillin (eg Benzil B, Penicillin G)
- Clindamycin (eg Dalacin-T, Clindamycin BIN, Zindaclin, Dalacin-C)
- Erythromycin (eg Erythrocin, Erythro L, Lauromycin)
- Metronidazole (eg Metronid, Deflamon, Flagyl): the most widely used antibiotic drug in treatment for tetanus, always associated with specific immunoglobulins.
Muscle relaxants: particularly useful in the case of tetanus associated with acute muscle spasticity
- Methocarbamol (eg Miowas, Robaxin): for adults, administer a dose of 1-2 mg drug directly into the IV tube, followed by a further dose of 1-2 mg by intravenous infusion (max. Initial dose: 3 g). Repeat this treatment every 6 hours; it is possible to insert a nasogastric tube. Subsequently, the drug can be taken in the form of a saline solution through a nasogastric tube. For children with tetanus, the drug is initially administered at a dose of 15 mg / kg every 6 hours. The maintenance dosage can be taken by intravenous infusion or by injection into tubes.
Anticonvulsants to reduce convulsions associated with tetanus:
- Diazepam (benzodiazepines: eg Micropam, Ansiolin, Diazepam FN, Valium, Diazepam, Valpinax) for affected newborns (0-4 weeks of life), it is recommended to administer 0.83 - 1.67 mg / kg every hour by continuous intravenous infusion; alternatively, the drug can be taken at a dose of 1.67 - 3.33 mg / kg for slow intravenous infusion every 2 hours, for a total of 20-40 mg per kilo of drug. Diazepam is not considered a first choice drug for newborns due to the content of benzyl alcohol and propylene glycol. When the child is aged between 1 month and 5 years, the recommended dosage is modified: 1-2 mg of drug by intramuscular / slow intravenous, repeated every 3-4 hours when necessary; alternatively, administer 15 mg / kg per day divided into doses, every 2 hours. Over 5 years, the dose for tetanus treatment is 5-10 mg administered every 3-4 hours as needed.
Pharmacisedatives to calm the patient suffering from tetanus:
- Chlorpromazine (eg. Clorpr C, Prozin) intramuscularly take 25-50 mg of drug 3-4 times a day, possibly in association with barbiturates. The total dose and frequency of drug administration should be established by the doctor based on the patient's response to treatment, starting with a rather low posology to gradually increase it. For intravenous use, take 25-50 mg of active diluted at least in 1 mg / ml, administered at a rate of 1 mg per minute.
Antipyretic drugs : useful for lowering the fever associated with tetanus. We also recommend drinking plenty of fluids and eating light food.
- Paracetamol (or acetaminophen: eg Tachipirina, Acetamol, BUSCOPAN COMPOSITUM) take the drug orally in the form of tablets, syrup, effervescent sachets or suppositories; it is recommended to take paracetamol at a dosage of 325-650 mg every 4-6 hours for 6-8 consecutive days, to bring down the fever. The drug can also be taken intravenously: 1 gram every 6 hours or 650 mg every 4 hours for adults and adolescents weighing more than 50 kilos: if the patient weighs less than 50 kilos, give 15mg / kg every 6 hours or 12, 5 mg / kg every 4 hours.
Do not administer aspirin (acetylsalicylic acid) to children under the age of 12.
Sometimes, surgery is useful to clean the lesion and remove the source of the poison.
Tetanus: prophylaxis
Vaccination is the most effective and intelligent method to prevent tetanus: it is important to remember that, in Italy, the tetanus vaccine is mandatory.
Primary immunization consists in the administration of 3 doses of combined vaccine, to be injected with an interval of one month from the other (for children under 10 years). This vaccination scheme is useful for guaranteeing immunization against the disease both during childhood and for the two booster vaccinations: the first to be carried out during the beginning of primary school, the second at the end of the school cycle. It is recommended to administer a booster dose in case of suspected tetanus injury, even after primary vaccination.
An adult man who has already taken at least 5 doses of vaccine can be considered almost immune to tetanus for life.
The following are available on the market:
- Anatetall Iniett (adsorbed tetanus vaccine)
- Imovax Tetanus (adsorbed tetanus vaccine)
- Infanrix Hexa (vaccine for tetanus, diphtheria, pertussis, hepatitis B, poliomyelitis)
