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Clinical Experiences in the Treatment of Tetanus

W. A. ALTEMEIER, M.D.; W. R. CULBERTSON, M.D.; L. L. GONZALEZ, M.D.
AMA Arch Surg. 1960;80(6):977-985. doi:10.1001/archsurg.1960.01290230095012.
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Tetanus, one of the most dreaded complications of wounds, continues to be a serious clinical problem. Neither its incidence nor its mortality appear to have been significantly decreased in civilian practice during the past 20 years by programs or active immunity.1

Large doses of antitetanic serum have been ineffective in preventing death during this violent disease, particularly in those patients with incubation periods of less than six days. The military experience of World War I and of the Korean War has demonstrated conclusively the superior prophylactic effectiveness of tetanus toxoid in producing immunity, but this valuable lesson has not been transferred to civilian life on a broad scale as yet.

Equally disappointing has been the apparent failure of prophylactic antibiotic therapy in wounded persons to reduce the number of cases of tetanus or to alter the course of the disease per se, once it has become established.2

The

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