Serologic therapy of tetanus in the United States, 1965-1971
P. A. Blake, R. A. Feldman, T. M. Buchanan, G. F. Brooks and J. V. Bennett
To study the influence of tetanus antitoxins on the outcome of human
tatanus, we analyzed data on 545 cases reported to the Center for Disease
Control from 1965 through 1971. Patients treated with antitoxin had a
significantly lower case-fatality ratio than untreated patients, and the
effect of serotherapy was not modified significantly by the age or race of
the subjects. Antitoxin of equine origin and human tetanus immune globulin
(TIG) were equally effective. The data on the effect of different doses of
TIG suggest that 500 units may be as effective as the currently recommended
therapeutic dose of 3,000 to 10,000 units. The importance of possible bias
introduced by unmeasured factors such as quality of supportive therapy
could not be determined, but confounding by 11 recorded potentially
confounding factors was minimal.
