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A comparison of the value of 200,000 I.U. of tetanus antitoxin (horse) with 10,000 I.U. in the treatment of tetanus

1968; Wiley; Volume: 9; Issue: 4 Linguagem: Inglês

10.1002/cpt196894465

1532-6535

B. J. Vakil, T. H. Tulpule, P. Armitage, Laurence Després,

Botulinum Toxin and Related Neurological Disorders

This is the last of a series of therapeutic trials designed to decide the value of equine antitoxin in tetanus. In the first study antitoxin was administered to half the patients and withheld from half. It was concluded that antitoxin (200,000 I.U.) reduced mortality. Sequential analysis was used for ethical reasons. Since antitoxin appeared useful it was obviously desirable to discover the minimum effective dose of this expensive and sometimes dangerous treatment. Plainly it was impermissible, on ethical grounds, to include a group of untreated patients as controls in subsequent dosage comparisons. It was therefore decided to use the dose of antitoxin found effective in the first study as a reference Iotandard for the subsequent trials. This seemed to be scientifically justifiable as well as ethically permissible. The series comprises doses ranging between 500,000 I.U. and 10,000 I.U. It is concluded that antitoxin reduces the mortality in tetanus, and that 10,000 I.U. is an adequate dose.