TETANUS ANTITOXIN ( EQUINE)

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    Equine tetanus antitoxin should no longer be used, as there is a risk of hypersensitivity and serum sickness.
    It should be replaced by human tetanus immunoglobulin.

     

    Therapeutic action

    • Neutralisation of tetanus toxin. Tetanus antiserum provides temporary passive immunity against tetanus for 2 weeks.

    Indications

    • Prevention of tetanus in wound management, in patients non immunised or incompletely immunised or in patients whose immunisation status is unknown, in combination with tetanus vaccine
    • Treatment of clinical tetanus

    Composition, forms and strengths, route of administration

    • Solution prepared from the serum of horses immunised against tetanus toxin
    • 1500 IU in 1 ml ampoule, for IM injection. DO NOT ADMINISTER BY IV ROUTE.

    Dosage and duration

    Prevention of tetanus

    • Tetanus antiserum is administered in the event of tetanus-prone wounds, e.g. wounds with fracture, deep penetrating wounds, bite wounds, wounds containing foreign bodies, wounds contaminated with soil, infected wounds, extensive tissue damage (contusions, burns).
      Child and adult: 1500 IU single dose; 3000 IU if more than 24 hours has elapsed
    • It is administered as soon as possible after injury, along with the tetanus vaccine, in a separate syringe and injection site.

     

    Treatment of tetanus

    • Neonate: 1500 IU single dose
    • Child and adult: 10 000 IU single dose

    Contra-indications, adverse effects, precautions

    • Do not administer to patients with known allergy to tetanus antiserum.
    • May cause: hypersensitivity reactions, anaphylactic shock, Quinke oedema; serum sickness up to 10 days after injection.
    • Administer following Besredka's method: inject 0.1 ml by SC route and wait 15 minutes; if no local or general allergic reactions occur, inject 0.25 ml by SC route and wait 15 minutes; if no reactions, administer the injection by IM route.
    • Ensure that the injection does not enter a blood vessel (risk of shock): aspirate prior to injection to confirm that the needle is not in a vein.
    • Pregnancy: no contra-indication
    • Breast-feeding: no contra-indication

    Remarks

    • Equine tetanus antitoxin is not included in the WHO list of essential medicines.

    Storage

     
    – Between 2 °C and 8 °C. Do not freeze.