Experience of use of magnesium sulfate in the treatment of tetanus in a tertiary referral Infectious Disease Hospital, Kolkata, India

Background: Tetanus is still a public health problem in developing countries with high morbidity and mortality. Aims and Objectives: To evaluate the effects of magnesium sulfate in the treatment of moderate to very severe tetanus cases. Patients and Methods: Eighty-six patients suffering from of moderate to very severe tetanus, treated with injection magnesium sulphate in combination with injection diazepam were evaluated and compared to the tetanus patients from the hospital record (treated with only diazepam) regarding outcomes. Results: The average duration of refllex spasm was 12 vs. 8 days in moderate group, 18 vs. 15 days in severe group and 21 vs. 17 days in very severe group in the previous and study year respectively. Average duration of hospital stay was 20 vs. 17 days in moderate group, 27 vs. 22 days in severe group and 36 vs. 30 days in very severe group in the previous and study year respectively. It had been observed that in both severe and very severe tetanus cases, occurrence of autonomic instability, respiratory depression, aspiration pneumonia, cardiac arrhythmia and total death - all were decreased in the study period than previous year. Conclusion: Magnesium sulfate in combination with diazepam may be a better option in the treatment of tetanus particularly in developing countries with limited intensive care facility because of morbidity and mortality benefiits.