Neonatal Tetanus — Uganda (Neonatal population)
Source Control
Clean and debride the infected umbilical stump.
First Line Antibiotics
Benzylpenicillin 100,000 IU/kg IV every 12 hours for 7–10 days. OR Metronidazole 7.5 mg/kg IV or rectal every 6–8 hours for 7 days.
Neutralise Toxin
Tetanus immunoglobulin (TIG) 500 IU IM single dose. Give immediately before wound cleaning.
Sedation and Spasm Control
Diazepam 0.1–0.3 mg/kg IV every 2–4 hours as needed. OR Phenobarbital 5–10 mg/kg IM or IV every 12 hours.
Supportive Care
Keep in a quiet, dark room to minimise stimulation. Nutritional support by NGT. Maintain airway. IV fluids for hydration.
Prevention
Maternal tetanus toxoid immunisation during pregnancy (TT2+ schedule). Clean delivery practices: clean blade for cutting cord, clean cord care. Never apply traditional remedies to the umbilical stump.
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