This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (27)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

A Meta-analysis

Elias Abrutyn, MD; Jesse A. Berlin, ScD

JAMA. 1991;266(16):2262-2267.

Abstract
Objective.
—To assess the efficacy of intrathecal therapy with tetanus antibody (antitetanus equine serum or human tetanus immune globulin) in neonatal and adult tetanus using meta-analytical techniques.

Data Sources.
—Clinical trials identified by searching MEDLINE and by reviewing bibliographies of published articles.

Study Selection.
—Studies in English with concurrent controls treated without intrathecal therapy.

Data Extraction.
—Data were extracted by one author and verified by the second; conflicts were resolved by discussion.

Data Synthesis.
—No major treatment effect was found in neonatal tetanus when all studies were considered. A benefit was suggested for antitetanus equine serum in adult disease, but this finding should be accepted with caution. Subgroup analyses were limited in power. Methodological difficulties in neonatal and adult trials were common and safety has not been established.

Conclusions.
—Intrathecal therapy for tetanus with either antitetanus equine serum or human tetanus immune globulin is not of proven benefit and should only be given in the context of well-designed, controlled trials.

(JAMA. 1991;266:2262-2267)

Author Affiliations
From the Medical College of Pennsylvania, Veterans Affairs Medical Center, Section in Infectious Diseases, Philadelphia (Dr Abrutyn); and the Clinical Epidemiology Unit, Section of General Internal Medicine, University of Pennsylvania School of Medicine, Philadelphia (Dr Berlin).

Footnotes
Reprint requests to Veterans Affairs Medical Center, University and Woodland avenues, Philadelphia, PA 19104 (Dr Abrutyn).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Randomised controlled trial of tetanus treatment with antitetanus immunoglobulin by the intrathecal or intramuscular route
de Barros Miranda-Filho et al.
BMJ 2004;328:615.
ABSTRACT | FULL TEXT  

Comparison of Evidence of Treatment Effects in Randomized and Nonrandomized Studies
Ioannidis et al.
JAMA 2001;286:821-830.
ABSTRACT | FULL TEXT  

NEUROLOGICAL ASPECTS OF TROPICAL DISEASE: Tetanus
Farrar et al.
J. Neurol. Neurosurg. Psychiatry 2000;69:292-301.
FULL TEXT