Treatment:

Treatment may include:

• Antibiotics, including penicillin, clindamycin, erythromycin, or metronidazole (metronidazole has been most successful)
• Bedrest with a nonstimulating environment (dim light, reduced noise, and stable temperature)
• Medicine to reverse the poison (tetanus immune globulin)
• Muscle relaxers such as diazepam
• Sedatives
• Surgery to clean the wound and remove the source of the poison (debridement)

Breathing support with oxygen, a breathing tube, and a breathing machine may be necessary.

Expectations (prognosis):

Without treatment, one out of four infected people die. The death rate for newborns with untreated tetanus is even higher. With proper treatment, less than 10% of infected patients die.

Wounds on the head or face seem to be more dangerous than those on other parts of the body. If the person survives the acute illness, recovery is generally complete. Uncorrected episodes of hypoxia (lack of oxygen) caused by muscle spasms in the throat may lead to irreversible brain damage.

Complications:

• Airway obstruction
• Respiratory arrest
• Heart failure
• Pneumonia
• Fractures
• Brain damage due to lack of oxygen during spasms

Calling your health care provider:

Call your health care provider if you have an open wound, particularly if:

• You are injured outdoors.
• The wound has been in contact with soil.
• You have not received a tetanus booster (vaccine) within 5 years or you are not sure of your vaccination status.

Call for an appointment with your health care provider if you have never been immunized against tetanus as an adult or child, if your children have not been immunized, or if you are unsure of your tetanus immunization (vaccine) status.