Tetanus Immune Globulin

Human tetanus immune globulin (TIG) neutralizes circulating tetanospasmin and toxin in the wound but not toxin that is already fixed in the nervous system. Even though TIG does not ameliorate the clinical symptoms of tetanus, there is evidence that its administration significantly reduces mortality. 12 In a study of 545 cases of tetanus, Blake and colleagues reported that 500 IU was as effective as larger doses of TIG in reducing tetanus-induced mortality. 12 TIG should be administered intramuscularly opposite the site of tetanus toxoid administration. It should be given before wound debridement, since exotoxin may be released during wound manipulation.11 Repeated doses of TIG are unnecessary, since the half-life of the antitoxin is 28 days. 9

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