A1,
A2,
B,
C1,
C2,
D,
E,
F,
G-H,
I-K,
L,
M,
N,
O,
P1,
P2,
Q-R,
S,
T,
U-V,
W-Z
Tetanus Toxoid Pharmacology, Pharmacokinetics, Studies, Metabolism - Tetanus Toxoid USP
Tetanus Toxoid Pharmacology, Pharmacokinetics, Studies, Metabolism - Tetanus Toxoid USP
CLINICAL PHARMACOLOGY
Tetanus is an intoxication
manifested primarily by neuromuscular
dysfunction caused by a potent
exotoxin elaborated
by Clostridium tetani.
The occurrence of tetanus
in the United States has decreased dramatically from 560 reported
cases in 1947 to a record
low of 48 reported cases in 1987. Tetanus in the United States is
primarily a disease
of older adults. Of 99 tetanus
patients with complete information reported to the Centers for Disease
Control and Prevention (CDC) during 1987 and 1988, 68% were 50 years
of age, while only six were < 20 years of age. Overall, the case-fatality
rate was 21%.1
In 1992, 45 cases were reported
of which 82% were ³50 years of age.2
The disease
continues to occur almost exclusively among persons who are unvaccinated
or inadequately vaccinated or whose vaccination
histories are unknown or uncertain. 1
In 4% of tetanus cases
reported during 1987 and 1988, no
wound or other condition
was implicated. Non- acute
skin lesions, such
as ulcers, or medical conditions such
as abscesses, were reported in association
with 14% of cases. 1
Neonatal tetanus occurs
among infants born under unhygienic conditions to inadequately vaccinated
mothers. Vaccinated mothers confer protection to their infants through
transplacental
transfer of maternal
antibody. From 1972 through 1984, 29 cases of neonatal
tetanus were reported
in the United States. No
cases of neonatal tetanus
were reported in the period 1985 to 1989.1
Spores of C. tetani are ubiquitous. Serologic tests indicate
that naturally acquired
immunity to tetanus
toxin does not occur in
the United States.1 Thus, universal
primary vaccination, with subsequent maintenance of adequate antitoxin
levels by means of appropriately timed boosters, is necessary to
protect persons among all age-groups. Tetanus toxoid
is a highly effective antigen,
and a completed primary
series generally induces
protective levels
of neutralizing antibodies to tetanus
toxin that persist for
³10 years.1
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