Indications
Tetanus antitoxin (equine) is used to prevent tetanus after a tetanus-prone wound (deep, dirty or contaminated wounds, burns or animal bites) in people who are not fully vaccinated, and to help treat established tetanus. It is used where human tetanus immunoglobulin is not available. It is always combined with proper wound care and tetanus vaccination.
How It Works
The antitoxin is made from the serum of horses immunised against tetanus. It contains antibodies that bind and neutralise tetanus toxin circulating in the body before it attaches to nerves. This gives immediate but short-lived (passive) protection. It cannot reverse toxin already bound to nerves, so early use matters. The tetanus vaccine is also given to build lasting immunity.
Dosage and Administration
Tetanus antitoxin is given only by a doctor or nurse, usually into a muscle, or into a vein for treatment of tetanus. Because it comes from horse serum, a skin sensitivity test is usually done first. The dose depends on whether it is for prevention or treatment and on the wound, as prescribed. The vaccine is given with a separate syringe at a different site.
Interactions
It may be given at the same time as tetanus vaccine, but at a different site and with a different syringe. It may reduce the response to some live vaccines given soon after. Tell the team if you take medicines that weaken the immune system.
Contraindications
- Known allergy to horse serum or a previous reaction to an equine product: human tetanus immunoglobulin is preferred.
- A positive skin test needs special care; in true tetanus, the doctor weighs the risks.
Side Effects
Pain and swelling at the injection site and mild fever may occur. Serum sickness can develop 7 to 12 days later, with rash, itching, joint pain, swollen glands and fever. Severe allergic reactions (anaphylaxis) can occur shortly after the injection.
Get urgent medical help for swelling of the face or throat, difficulty breathing, wheezing, widespread rash or feeling faint after the injection, or for jaw stiffness, muscle spasms or difficulty swallowing after a wound.
Pregnancy and Lactation
Tetanus is life-threatening, so the antitoxin may be given in pregnancy and breastfeeding when needed. Pregnant women should also receive tetanus vaccination as advised, which protects the newborn.
Precautions and Warnings
Patients must be observed for at least 30 minutes after the injection, with adrenaline and resuscitation equipment ready. Tell the team about asthma, allergies or previous horse serum injections. Clean every wound well and complete the vaccine course.
Overdose
Overdose is unlikely as it is given by health staff. Larger doses may increase the chance of serum sickness, which is treated with medicines such as antihistamines or steroids.
Therapeutic Class
Antitoxin, equine immune serum (passive immunising agent against tetanus).
Storage
Store in a refrigerator at 2 to 8°C, do not freeze, protect from light. Hospital product: handle as directed on the pack.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.