In most parts of the world you get tetanus shots, some every 10 years, some places like england they don’t give you anymore after age 14 unless you get a really bad injury. This made me wonder about the effectiveness of common topical antibiotic ointments used after cuts, such as bacitracin against clostridium tetani aka tetanus. Bacitacin kills many gram postive bacteria, and tetanus is gram positive. Does it kill tetanus? Are there any doctors or scientists here who can answer this?
Tetanus is caused when the spores go very deep into wound. It’s unlikely that a topical antibiotic would be effective, regardless of how well it kills the bacteria.
Tetanus is also an anaerobic bacteria, which is why it is mainly a concern in deep or puncture wounds, as beowolf noted. Topical antibiotics are ineffective for this sort of infection.
In my experience in ERs, we will update a tetanus vaccine for dirty penetrating wounds if the last dose was more than 5 years ago. Clean, less deep wounds stick to the every 10 years schedule.
I find it amazing how survivable tetanus is when it used to be a death sentence. One of my grandpas got tetanus as a kid (he was born in 1913, so probably in the 1920s) and his class pooled their money to buy him a funeral wreath. A recent article I found said that in 1947 the mortality rate was 91%. When I was a teen in the 70s grandpa was still the only known person in our county to have survived. Now the mortality rate is only 13% for people under 60, even lower for mild or moderate cases.
Could that because most people have gotten a tetanus shot at some point in their lives, so even if it happened decades ago, they still have some protection?
Have there been any studies testing bacitracin against clostridium tetani aka tetanus?
I’m a licensed, non-practicing pharmacist. I’m sure there have been studies, and it didn’t work or the risks overrode the benefits, which was why I couldn’t find anything online; bacitracin is fine as a topical antibiotic (which is why it’s OTC), or even an irrigation or flush, but its intravenous use is extremely dangerous (toxic to the kidneys) and is rarely used unless nothing else works.
I have been involved in treating one case of tetanus. We all agreed that we hoped we never saw anything like that ever again. The patient was Amish and had never been in an environment where vaccines were required, so he had never had one.
Sara20, if you’ve had an injury and are wondering if you should get a tetanus shot, the answer is YES. If it’s been more than a few hours, they may also give you antitoxin to treat any infection that’s taken hold, should you have one.
He may also have received tetanus toxoid (not antitoxin; they’re not the same thing and I missed the edit window). In the days before a vaccine and antibiotics, this was used to treat active cases, by dislodging the toxin from cells, and it was invented in 1924.
I was gonna say, how foxy was your grandpa if he died as a kid and still had a grandchild.
Forget the deep puncture wound for a bit. It’s not as important as the fact that tetanus is not a local infection. Topical antibiotics are only useful for local infections.
Sure, the antibiotic might kill the bacteria before it gets in, but so would just using general cleaning, which is why you are told to clean a wound.
Where the deep wound part comes in is that the deep wound is what allows the infection to not be local. It gets in deep so it can spread around.
So what’s probably more useful is not asking about the antibiotic, but about whether any form of cleaning the wound has any effect on preventing tetanus infections. I’m not sure if you’ll find them, though, since the general idea is to err on the side of caution and give the shot before any signs of infection are present.
Oh, and since you are asking, you probably would be best off if whoever you know who was wounded would go get their shot. It’s not that big a deal.
I will say I would be curious at info on the use of antibiotics in tetanus, though. It is bacterial, not viral, so do any systemic (internal) antibiotics work with it?
The preferred agents are penicillin G or metronidazole, both in IV form. Other antibiotics can be used but don’t work as well.
How effective is a regular “tetanus shot” after exposure? As a kid, I heard “if you step on a nail, you have to get a tetanus shot”.
Naturally, the time I did step on a nail (sticking up through a board- went right through the sole of my sneaker and into my foot), I told nobody :smack:.
Luckily, I had my annual physical a couple days later, and happened to get a tetanus shot as part of it. I’ve always wondered whether that saved my life. I think I was 10 or 11 at the time.
I’m confused by this post. It seems to imply a belief that systemic antibiotics would work against a virus but not a bacteria which is exactly backwards. Antibiotics (whether topical, oral or injected) work against bacteria. Antibiotics do not work against viruses.