S.A.T. TETANUS ANTITOXIN Tetanus antitoxin is an injection of refined tetanus antitoxin. It is a solution of modified globulin prepared from antitetanus horse serum by peptic digestion and ammonium sulphate fractionation.
INDICATION AND DOSAGE 1. Prophylactic Use: 1500-3000 I.U. both for adults and children. Injection should be repeated after five to six days when wound contamination still persists. In those cases who have been immunized previously with tetanus toxoid, it is advisable to give a booster dose of tetanus toxoid only. For prophylactic use the antitoxin may be given by subcutaneous or intramuscular route.
Therapeutic Use: Tetanus antitoxin should be administered as early as possible. A case usually requires about 10000-200000 l.U. on average.
Usually 50000 I.U. of antitoxin should be given on the first and the following day of illness, and 10000 I.U. is repeated on the third, fourth and eighth day respectively.
The neonates with tetanus should receive 2000-100000 I.U. antitoxin within 24 hours of illness either a single or separate dose.
ADMINISTRATION PROCEDURE AND PRECAUTIONS
Before use the ampoule package must be examined with care. Any broken ampoules, or ampoules containing in dispersible precipitates or particles must be discarded.
A sensitivity test should always be done before the administration of antitoxin. Dilute the antitoxin to 1:10 with physiological saline (i.e. 0.1 ml of antitoxin + 0.9ml of saline). Inject 0.05ml of the diluted antitoxin intracutaneously on the flexor surface of the forearm. A positive reaction characterized by erythema, edema or infiltration appearing in 15-30 minutes denotes hypersensitiveness to horse serum preparation.
A negative reactor may be treated in the usual manner, a positive reactor must be desensitized When antitoxin administration is indispensable. The following desensitization procedure may be recommended: Dilute the antitoxin to 1:10 with sterile physiological saline, inject subcutaneously 0.2ml at first, observe for 30 minutes, if no reaction occurs, give another injection with increased dose. If no reaction occurs, give the third injection, and so forth. If still no reaction occurs then the administration of undiluted antitoxin can be started.
Intravenous route can be adopted only when no reaction occurs by intramuscular or hypodermic route: (a) Intravenous drip with glucose solution. (b) Intravenous: Warm the ampoule in a water bath to 37ºC before use. Injection should be done very slowly, not more than 4 ml per minute. For children not more than 0.8ml per Kg of body weight, and for adults not more than 40ml should be injected at one time. If any reaction occurs, intravenous injection must be stopped at once.
Adrenaline should always be at hand. In case of anaphylaxis, adrenaline should be given at once. All patients developed hypersensitive reactions following injection should be handled properly.
PACKAGE AND STORAGE Package for prophylactic use, each ampoule contains 1500I.U., 3000I.U. or 5000 I.U.. Package for therapeutic use, each ampoule contains 10000 l.U. or 20000 l.U.. Store in the dark at 2-8ºC .
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