Neonatal tetanus: incidence and improved outcome with diazepam

During a four-year prospective study at a referral hospital, 61 patients with neonatal tetanus were encountered and the contribution of continuous intravenous diazepam was noted. The over-all incidence during the study was 21.8/1000, with a mortality rate of 8.2 per cent. Signs associated with fatal outcome were hypothermia, generalized rigidity and opisthotonus. The mean dose of diazepam used was 25.8 mg/kg/day, in combination with sodium phenobarbitone (mean dose 10.7 mg/kg/day). The results suggest that high-dose intravenous (continuous) diazepam is effective, economical and feasible for reducing mortality in neonatal tetanus. Side-effects were minimal.