{ "schema_version": 1, "kind": "condition", "id": "tetanus-prophylaxis", "name": "Post-Exposure Tetanus Prophylaxis", "category": "infectious", "sources": "Egyptian National Drug Formulary - Antimicrobial 2023 · CDC Tetanus Wound Management Guidelines 2023 · Human Tetanus Immunoglobulin 100 IU/mL solution for injection SmPC sections 4.2 and 4.4 (eMC product 5547) · Tetanus Prophylaxis - StatPearls - NCBI Bookshelf - disease-level clinical article (tetanus-prophylaxis-full.txt)", "review_status": "reviewed", "verified_against": "Egyptian National Drug Formulary - Antimicrobial 2023 · Human Tetanus Immunoglobulin 100 IU/mL solution for injection SmPC sections 4.2 and 4.4 (eMC product 5547) · No dose - referral pathway, no medicine given in primary care · Tetanus Prophylaxis - StatPearls - NCBI Bookshelf - disease-level clinical article (tetanus-prophylaxis-full.txt)", "verified_date": "2026-08", "treatments": [ { "id": 1772, "generic": "Tetanus toxoid", "line": 1, "is_adjunct": false, "form": "injection", "strength_mg": null, "adult_dose": "0.5 mL IM single dose into deltoid muscle", "adult_duration": "single dose", "dose_source": "Egyptian National Drug Formulary - Antimicrobial 2023", "rationale": "Toxoid vaccine that stimulates active immunity against tetanus toxin, given after a wound when the immunisation history is inadequate or uncertain; post-exposure prophylaxis alongside wound debridement, not treatment for established tetanus.", "cautions": [ "For clean minor wounds, give a booster if >10 years since the last dose. For dirty or tetanus-prone wounds, give a booster if >5 years since the last dose.", "Thorough wound debridement and cleaning is mandatory." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "Children >= 2 months: 0.5 mL IM single dose (usually given as DTaP/Tdap)", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": [ { "label": "2 months and over", "age_min_months": 2, "age_max_months": 216, "dose_text": "0.5 mL IM single dose (usually given as DTaP/Tdap)" } ], "peds_doses": null, "brands": [], "condition_id": "tetanus-prophylaxis" }, { "id": 1774, "generic": "Referral & safety-netting (no drug therapy)", "line": 1, "is_adjunct": false, "form": null, "strength_mg": null, "adult_dose": null, "adult_duration": null, "dose_source": "No dose - referral pathway, no medicine given in primary care", "rationale": "Carries the referral criteria and warning signs for this condition, which apply whichever treatment is chosen.", "cautions": [ "RED FLAG - In HIV/AIDS patients, HTIG is indicated regardless of immunization status or wound risk classification, overriding the usual criteria.", "When tetanus immune globulin is given, part of the dose must be infiltrated around the wound itself, not all of it into a distant muscle.", "Tetanus immune globulin can still be given up to 21 days after the injury in an unvaccinated patient who presents late.", "RED FLAG - Do not give the vaccine to a patient who had an anaphylactic reaction to a previous dose, or who developed encephalopathy not otherwise explained within 7 days of a previous dose.", "Take extra care before vaccinating a patient who had Guillain-Barre syndrome within 6 weeks of a previous dose, a previous Arthus-type reaction, or an underlying neurological condition.", "Tdap is indicated in pregnancy between 27 and 36 weeks of gestation.", "The pregnancy dose is repeated in every pregnancy regardless of when the last tetanus dose was given, and an unvaccinated pregnant woman needs a series of three doses 4 weeks apart.", "A patient with no previous tetanus immunisation needs a full three-dose primary course, not a single injection.", "A high-risk wound means one that is contaminated, a puncture, an avulsion, or caused by a missile, crushing, burns, an animal or human bite, or frostbite; a low-risk wound is clean and minor.", "Tetanus-prone wounds may be left open rather than closed, to avoid creating the anaerobic conditions the organism needs.", "Give prophylaxis as soon as possible after the injury, and still give it when the patient presents late, because the incubation period is long and variable." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": null, "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [], "condition_id": "tetanus-prophylaxis" }, { "id": 1773, "generic": "Tetanus immune globulin (human)", "line": 1, "is_adjunct": true, "form": "injection", "strength_mg": null, "adult_dose": "250 IU IM as a single dose; 500 IU where the wound is infected and cannot be surgically cleaned within 24 hours, or is deep or heavily contaminated", "adult_duration": "single dose", "dose_source": "Human Tetanus Immunoglobulin 100 IU/mL solution for injection SmPC sections 4.2 and 4.4 (eMC product 5547)", "rationale": "Human tetanus immunoglobulin provides immediate passive immunity for tetanus-prone wounds in unimmunized patients", "cautions": [ "Indicated for dirty wounds in individuals with incomplete (<3 doses) or unknown vaccination history.", "Inject into a separate anatomical site from tetanus vaccine using separate syringe.", "If the tetanus vaccine is being given at the same visit, it goes in a different site - not the same muscle, not mixed.", "IgA deficiency is the anaphylaxis risk here - these patients can react to any IgA-containing blood product.", "For prophylaxis, if intramuscular administration is contraindicated (bleeding disorders), the injection can be administered subcutaneously." ], "peds_mgkg_low": null, "peds_mgkg_high": null, "peds_max_mg": null, "peds_basis": null, "peds_unit": null, "peds_note": "250 IU IM single dose for all ages", "peds_min_weight_kg": null, "peds_max_weight_kg": null, "peds_age_min_months": null, "peds_age_max_months": null, "peds_age_bands": null, "peds_doses": null, "brands": [ { "trade_name": "BERIGLOBIN P 160MG/ML I.M.AMP.", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CSL BEHERING-GMBH -GERMANY > 2S PHARMA GROUP", "price_egp": 30.0, "pack_count": null, "unit_price": null, "strength_mg": 160.0, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null }, { "trade_name": "TETAGAM P 250 I.U./ML I.M INJECTION", "scientific_name": null, "normalized_ingredient": null, "manufacturer": "CSL BEHERING-GMBH -GERMANY > 2S PHARMA GROUP", "price_egp": 40.0, "pack_count": null, "unit_price": null, "strength_mg": null, "exact_strength": true, "exact_form": true, "discontinued": false, "also_contains": null } ], "condition_id": "tetanus-prophylaxis" } ] }