Failure of intrathecal antitetanus serum to improve survival in neonatal tetanus

In a prospective study, 161 infants with neonatal tetanus were randomised to receive (a) standard treatment, or (b) standard treatment together with intrathecal equine antitetanus serum, or (c) intrathecal antitetanus serum with systemic betamethasone. There was no difference in survival between the three treatment groups in infants with severe tetanus, but in mild tetanus those who received standard treatment alone had an improved survival rate. Parenteral intramuscular diazepam as a sedative was found to be preferable to paraldehyde, as the latter was associated with a higher incidence of secondary infections.