Clinical definition:

Infection caused by C. tetani characterized by acute onset of muscle stiffness and muscular contractions.


Neonate, Infant, Child & Adolescent

Preferred antibiotic choice
Metronidazole (IV)Injection: 500 mg in 100 mL vial.


o   First week of life (7 days or less): 7.5 mg/kg/dose 12 hourly

o   8 days of age & older: 7.5 mg/kg/dose 8 hourly, maximum dose 400 mg 8 hourly

10 days
Alternative antibiotic choice
Benzylpenicillin (IV)Powder for injection: 600 mg (= 1 million IU); 3 g (= 5 million IU) (sodium or potassium salt) in vial.25 000 IU/kg/dose 6 hourly, maximum dose 5 million IU/kg/dose 6 hourly10 days



  • Also administer Human Tetanus Immunoglobulin (IM): neonates 500 IU, children 2000 IU, adults 3000-6000 IU.
  • Wound care and debridement/umblical cord care is required.
  • Administer a booster dose of tetanus vaccine (not required in immunized patients who have received a booster dose within the past 5 years).