Penatalaksanaan Tetanus Neonatorum

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Sunita

Penatalaksanaan tetanus neonatorum atau TN bertujuan untuk mengeradikasi kuman Clostridium tetani, menetralkan toksin, dan memberikan terapi suportif spesifik sesuai keparahan penyakit.

Terapi Antitoksin

Terapi antitoksin menggunakan imunoglobulin antitetanus (human tetanus immune globulin atau HTIG) dari serum manusia maupun kuda (antitetanus serum atau ATS) masih menjadi terapi pilihan pada penanganan tetanus.[27-29]

Referensi

22. Lam PK, Trieu HT, Lubis IND, et al. Prognosis of neonatal tetanus in the modern management era: An observational study in 107 Vietnamese infants. Int J Infect Dis. 2015;33:e7–11.
27. Centers for Disease Control and Prevention. Tetanus. Epidemiology and Prevention of Vaccine-Preventable Disease. 2015. https://www.cdc.gov/vaccines/pubs/pinkbook/tetanus.html
28. Liu ZC, Zhou B, Tan SK. Tetanus vaccines: WHO position paper – February 2017. Relev Epidemiol Hebd. 2017;92(6):53–76. http://www.scientific.net/AMR.658.399
29. Leman MM, Tumbelaka AR. Penggunaan Anti Tetanus Serum dan Human Tetanus Immunoglobulin pada Tetanus Anak. Sari Pediatr. 2010;12(4):283–8.
30. Rodrigo C, Fernando D, Rajapakse S. Pharmacological management of tetanus: an evidence-based review. Crit Care. 2014 Mar 26;18(2):217.
31. Ahmadsyah I, Salim A. Treatment of tetanus: An open study to compare the efficacy of procaine penicillin and metronidazole. Br Med J (Clin Res Ed). 1985;291(6496):648–50.
32. Trieu HT, Lubis IN, Qui PT, Yen LM, Wills B, Louise Thwaites C, et al. Neonatal tetanus in Vietnam: Comprehensive intensive care support improves mortality. J Pediatric Infect Dis Soc. 2016;5(2):227–30.
33. DIETRICH HF. Tetanus neonatorum; report of 2 cases with omphalectomy and recovery. J Am Med Assoc. 1951 Nov 10;147(11):1038–40.
34. Okoromah CA, Lesi AF. Diazepam for treating tetanus. Cochrane Database Syst Rev. 2004;(1). http://doi.wiley.com/10.1002/14651858.CD003954.pub2
35. Joint Formulary Committee. British National Formulary. BNF 70. London; 2015.
36. Yaucher NE, Fish JT, Smith HW, Wells JA. Propylene Glycol–Associated Renal Toxicity from Lorazepam Infusion. Pharmacotherapy. 2003 Sep;23(9):1094–9. http://doi.wiley.com/10.1592/phco.23.10.1094.32762
37. Yahwak JA, Riker RR, Fraser GL, Subak-Sharpe S. Determination of a Lorazepam Dose Threshold for Using the Osmol Gap to Monitor for Propylene Glycol Toxicity. Pharmacotherapy. 2008 Aug;28(8):984–91. http://doi.wiley.com/10.1592/phco.28.8.984
38. McGregor C, Machin A, White J. In-patient benzodiazepine withdrawal: comparison of fixed and symptom-triggered taper methods. Drug Alcohol Rev. 2003 Jan 1;22(2):175–80. http://doi.wiley.com/10.1080/09595230100100615
39. Trujillo MH, Castillo A, España J, et al. Impact of Intensive Care Management on the Prognosis of Tetanus. Chest. 1987 Jul;92(1):63–5. http://linkinghub.elsevier.com/retrieve/pii/S0012369216376383
40. Lambo JA, Anokye EA. Prognostic factors for mortality in neonatal tetanus: A systematic review and meta-analysis. Int J Infect Dis. 2013;17(12):e1100–10. http://dx.doi.org/10.1016/j.ijid.2013.05.016

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Penatalaksanaan Tetanus Neonatorum

Referensi

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