Human tetanus immunoglobulin will at best neutralize only circulating toxin, and does not affect toxins already fixed in the central nervous system. Symptoms already present are not ameliorated.
Present recommendations for human tetanus immunoglobulin are 3000 to 6000 IU intramuscularly, although a single 500-IU dose may be as effective. Equine antitetanus serum 1500 to 10 000 IU can be used after testing and desensitization if human tetanus immunoglobulin is not available.
Intrathecal administration of tetanus antitoxin is still controversial. Meta-analysis of available studies suggests no benefit.
Side-effects of human tetanus immunoglobulin include fever, shivering, chest or back pains, tachycardia, and hypotension.
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