Evaluation of cholinesterase-restoring agents in the areatment of tetanus in man

Abstract

The use of cholinesterase-restoring therapy for clinical tetanus in man was evaluated. Two groups of 100 randomly selected patients were treated. Group A was treated with the usual therapy (antiserum to tetanus toxin, in a single dose of 20,000-50,000 international units; procaine penicillin, 400,000 units daily for five days; 12.5-100 mg of chlorpromazine as required was given four times daily according to the age of the patient). Group B was treated in the same way but with cholinesterase-restoring agents (pralidoxime methanesulphonate, 40 mg/ kg daily im; cyanocobalamin, 100 µg/kg daily 00; both were given for 10 days). The total mortality rate was lower in group B (39.2%) than in group A (47.1% ), but this was not statistically significant. Comparisons of the mortality rates of the different severities (mild, moderate, and severe) on admission showed a statistically significant improvement in recovery when the cholinesterase-restoring therapy was used.