BayTet (tetanus immune globulin (human) solvent/detergent treated 250 units) is indicated for prophylaxis against tetanus following injury in patients whose immunization is incomplete or uncertain (see below). It is also indicated, although evidence of effectiveness is limited, in the regimen of treatment of active cases of tetanus.7,8,15 A thorough attempt must be made to determine whether a patient has completed primary vaccination. Patients with unknown or uncertain previous vaccination histories should be considered to have had no previous tetanus toxoid doses. Persons who had military service since 1941 can be considered to have received at least one dose, and although most of them may have completed a primary series of tetanus toxoid, this cannot be assumed for each individual. Patients who have not completed a primary series may require tetanus toxoid and passive immunization at the time of wound cleaning and debridement.2 The following table is a summary guide to tetanus prophylaxis in wound management: Guide to Tetanus Prophylaxis in Wound Management2
History of Tetanus Immunization (Doses) Clean, Minor Wounds All Other Wounds* Td† TIG‡ Td TIG Uncertain or less than 3 Yes No Yes Yes 3 or more§ No|| No No¶ No * Such as, but not limited to, wounds contaminated with dirt, feces, soil, and saliva; puncture wounds; avulsions; and wounds resulting from missiles, crushing, burns and frostbite.
† Adult type tetanus and diphtheria toxoids. If the patient is less than 7 years old, DT or DTP is preferred to tetanus toxoid alone. For persons ≥ 7 years of age, Td is preferred to tetanus toxoid alone. (see DOSAGE AND ADMINISTRATION)
‡ Tetanus Immune Globulin (Human). §If only three doses of fluid tetanus toxoid have been received, a fourth dose of toxoid, preferably an adsorbed toxoid, should be given.
|| Yes if more than 10 years since the last dose.
¶ Yes if more than 5 years since the last dose. (More frequent boosters are not needed and can accentuate side effects).