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January 13, 1969

Management of Tetanus

JAMA. 1969;207(2):370. doi:10.1001/jama.1969.03150150082035

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To the Editor:—  In reference to comments on Management of Clinical Tetanus (206:375, 1968), certain qualifying remarks are indicated.Sole reliance on antibiotic prophylaxis of tetanus is not indicated in our present state of knowledge, according to a statement approved by the International Conference on Tetanus held in Berne, Switzerland, July 15-19, 1966 (Lancet2:489, 1966).Repeated doses of antitoxin are not justified in treating clinical tetanus. The minimum dose is 20,000 units and the maximal dose is 60,-000 units for non-neonatal tetanus when heterologous products (equine or bovine) are used, whereas smaller amounts (3,000 to 6,000 units) of homologous antitoxin (tetanus immune globulin, human) have been considered adequate (Top, F. H., Sr. (ed.): Communicable and Infectious Diseases, ed 6, St. Louis: C. V. Mosby Co., 1968, p 620).