Treatment of Tetanus

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If the wound is large, standard practice is to remove as much of the damaged and contaminated muscle as possible by surgery. This will limit the amount of the poison tetanospasmin toxin that can be produced. The surgical process is called debridement.

Where tetanus has become established, the treatment is to give antibodies that work against the poison (known as tetanus antitoxins). This will usually be human antitetanus globulin. Large doses of antibiotic drugs, antimicrobial drugs (such as metronidazole) and a muscle relaxant (such as diazepam) are usually given once a tetanus diagnosis is suspected.

Giving the drug diazepam directly into a vein can control the muscle spasms themselves. In extreme cases it may be necessary to paralyse the patient with curare (a naturally occurring substance that paralyses the nerves to muscles) and use a machine to keep the person breathing.

Maintaining breathing and nutrition are very important for helping someone to survive tetanus as the infection can cause severe energy loss. Maintaining a calorie intake of 3500-4000 calories with at least 100g of protein by giving it in liquid and semi-liquid form via a stomach tube is recommended. In some cases, feeding via an intravenous drip may be necessary.