PENICILLIN IN PREVENTION OF TETANUS

The role of cell population kinetics in the efficacy of penicillin--an experimental analysis and stochastic modeling of the tumour tetanus and wound tetanus of the mouse

When investigating tetanus lethality summation curves of mice under comparable quantitative conditions following a temporarily limited administration of penicillin, the curves obtained can be calculated by the kinetics of tumour cells or wound fibroblasts. In particular, it has been shown that the optimal efficacy of penicillin, after short-time usage as compared with a long-time administration schedule, is determined by the generation time of the tetanus rods as a function of the mitotic cycle of the "pace-making" tumour cells or wound fibroblasts. Further variables of the mathematical model imply the pharmacokinetics of penicillin and the recovery process of the "hit" tetanus rods. From these results some basic experimental and clinical tetanus issues can be elucidated; thus, the mitosis theory of tetanus is being verified for the stage of incubation and of clinical manifestation, while the classical necrosis theory of the pathogenesis of tetanus infection should be valid only for the final stage.

Comparative trial of three heterologous anti-tetanus sera

The three heterologous anti-sera currently provided for tetanus prophylaxis have been compared with reference to the production of untoward reactions in 498 patients, and to the blood antitoxin concentrations produced in 76 patients. Equine serum, although giving rise to more reactions, was the only effective agent in terms of the levels and duration of serum antitoxin concentration produced. The local response to a test dose of any of the three sera is not a reliable guide to immediate or late general reactions.

Estudo comparativo da imunização antitetânica com o uso do toxóide tetânico fluido e precipitado pelo alúmen

Os autores fazem um estudo comparativo da imunização antitetânica em um grupo de crianças, utilizando toxóide fluido contendo 20 Lf/cm3 e toxóide precipitado pelo alúmen contendo 2 Lf/cm3. O esquema utilizado foi de 3 doses com intervalos de 21 dias entre cada dose, aplicando o toxóide fluido na dose de 1 em3 em um grupo de crianças; 0,5 cm3 em outro grupo e em um terceiro grupo o toxóide tetánico precipitado pelo alúmen na dose de 1 cm3. Foram realizadas dosagens de antitoxinas no 7" e 21" dia após cada aplicação dos toxóides. Os autores obtiveram níveis protetores em todos os casos após a 3.ª dose com ambos os toxóides. Com o toxóide tetánico precipitado pelo alúmen observaram que os níveis protetores surgiram já com a 2.ª dose. enquanto que com o toxóide fluido houve necessidade da 3.ª dose para serem atingidos níveis protetores na totalidade dos casos. A titulagem realizada após a 3.ª dose não mostrou diferenças significativas entre os títulos obtidos com 2 Lf do toxóide precipitado e os obtidos com 20 Lf do toxóide fluido, sendo porém, alcançados níveis menores com a dose de 10 Lf do toxóide fluido. Não observaram para efeitos graves com nenhum dos toxóides, sendo referido, contudo, manifestações dolorosas no local da aplicação do toxóide precipitado.

Infection in missle wounds

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Clostridium tetani in a Metropolitan Area: A Limited Survey Incorporating a Simplified in Vitro Identification Test

In a limited survey, three toxigenic and one nontoxigenic strains of Clostridium tetani were isolated from 18 environmental samples from metropolitan Boston. No C. tetani was found in 100 samples of human feces, 20 samples of dog feces, and two samples of horse feces. A simple modification of the halo precipitin test was studied in conjunction with the mouse lethality test for tetanus toxigenicity and was found to be a useful, although not a wholly definitive, technique.