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Tetanus immune globulin is used to prevent tetanus infection in people who may have been exposed to Clostridium tetani bacteria. It counteracts the toxins produced by the bacteria. This differs from the tetanus vaccine, which is given to prevent infection before exposure. Additionally, it is sometimes used to treat confirmed tetanus infections.
Clostridium tetani bacteria are typically found in soil, and enter the blood stream through a break in the skin. Once inside the body, the bacteria release a toxin called tetanospasmin. The toxin blocks nerve signals to the muscles causing them to spasm, sometimes severely enough to cause muscle tears and bone fractures. In addition to tetanus immune globulin, treatment may include antibiotics and supportive therapies like breathing support.
For both adults and children, the injected dose of tetanus immune globulin for possible exposure is 250 to 500 units injected into the muscle. The larger dose is used when treatment is not sought immediately after injury. If infection has been confirmed, the dose may range from 500 to 6,000 units. Side effects and reactions to tetanus immune globulin include hives, difficulty breathing, itching, and tiredness.
Tetanus immune globulin is in the pregnancy category C, which means that animal studies have shown adverse affects to the fetus and there are no sufficient human studies, or there are no animal or human studies. Pregnant women who do not definitely have the disease should weigh the benefits of the drug against potential risks.
In the United States a tetanus immunization is routinely given from infancy as part of the "DTaP" vaccine, which stands for diptheria, tetanus and pertussis. Vaccinations are typically given at two months, four months, six months, 15 to 18 months, and four to six years. A booster should typically be given every ten years. Tetanus immune globulin is usually recommended after any potential exposure if the patient does know the date of the last vaccination, or if it has been more than five years since the last vaccination as a preventative measure.
Recovery after the administration of tetanus immune globulin is expected for about 90 percent of patients. Possible complications are heart attack, brain damage from lack of oxygen, and pneumonia. The tetanus vaccine can be given 12 weeks after the immune globulin is administered. Having had tetanus does not offer protection from future infections, so continued vaccination is necessary.