• C G Chikhani and K Kumar.
• Department of Accident and Emergency Medicine, Milton Keynes General Hospital, England.
• Arch Emerg Med. 1988 Mar 1;5(1):4-11.

AbstractThe various guidelines for the administration of tetanus toxoid and antitetanus immunoglobulin are not only complicated, but also have never been supported by any scientific experimental studies. This study has measured the antibody levels in a random sample of 157 patients presenting to an accident and emergency department. Levels were measured before and after boosting doses. The results show that, in the sample analyzed, even those patients who had their last 'booster' over 10 years ago, had a satisfactory immunoglobulin level. In fact, no patient in the study had a level below the 'protective level'. Bearing in mind the small number of patients in the study, it could be argued that the level of immunity against tetanus in the United Kingdom is likely to be higher than assumed. If this is proven to be correct, then the length of time between booster injections of toxoid can be extended and the use of Human Antitetanus Immunoglobulin can be further restricted.

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