There is no cure for tetanus. Treatment of tetanus involves wound care, medications to ease symptoms and supportive care.
Spores of clostridium tetani are deposited in a contaminated wound. These spores multiply rapidly and produce a neurotoxin that interferes with nerves that control muscle movement. Cleaning of wound is essential as it removes and prevents growth of tetanus spores. Cleaning of wound includes removing dirt, foreign objects and dead tissue from the wound.
- Antitoxin: In people with contaminated wounds, the doctor will give a tetanus antitoxin, such as tetanus immune globulin. TIG (tetanus immunoglobulin) is given as soon as possible, even if the person is vaccinated. Tetanus immunoglobulin can neutralise tetanospasmin toxin (but only the toxin that hasn't yet bonded to nerve tissue). It is given intravenously (injected into a vein) and provides immediate short-term protection against tetanus. TIG provides only short-term protection; it does not replace the long-term effects of vaccination.
- Antibiotics: Antibiotics such as penicillin and metronidazole are given for tetanus treatment. Antibiotics inhibit multiplication and growth of Clostridium tetani and synthesis of neurotoxin that causes muscle spasms and stiffness. Patients allergic to penicillin or metronidazole may be given tetracycline. Antibiotics, may be given orally or by injection, to fight tetanus bacteria.
- Sedatives: Powerful anticonvulsants (with sedative effect) are given to control muscle spasms. Commonly used anticonvulsants in tetanus include diazepam, midazolam and phenobarbital. These drugs relax the muscles, reduce anxiety and are very effective as sedatives. Treatment is gradually lessened to reduce the likelihood or severity of withdrawal symptoms.
- Muscle relaxants: Muscle relaxants such as baclofen and dantrolene ease the symptoms of muscle stiffness and spasms.
- Other drugs: Certain other medicines such as magnesium sulphate and certain beta blockers may be given in a patient with tetanus. Beta blockers are useful to regulate involuntary muscle activity, such as your heartbeat and breathing. Some cases may need morphine for sedation.
- Ventilation: Tetanus infection in most cases needs prolonged treatment in an intensive care setting. As the illness (muscle spasm) and effects of sedatives and other medicines may cause shallow breathing, some people may need to be supported temporarily by a ventilator.
- Nutrition: Muscle spasm (of throat and jaw) and effects of sedatives can prevent adequate oral intake of calories. In addition to this, a person with tetanus requires a high daily calorie intake because of increased muscle activity. Intensive nutritional support is needed in people with tetanus.
Getting tetanus doesn't provide immunity to the bacteria afterward. Vaccination with tetanus vaccine is needed to prevent future tetanus infection.