TETANUS ANTITOXIN ( EQUINE)


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 -