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คําแนะนําเก่ยวกับการให้ Tetanus Antitoxin , Tetanus Toxoid and Antibiotics คําแนะนําเก่ยวกับการให tetanus antitoxin , tetanus toxoid , and antibiotics ในทารกแรกเกดท่ ไมมอาการเจ็บปวยใดๆ และตรวจรางกายไมพบส ่งผดปกต Tetanus Toxoid (TT) Tetanus Antitoxin (TAT) Antibiotics* CBC, Hemoculture and 3-5 day observation ** มารดาไมมประวัต ได TT ระหวางตั งครรภ และ Unsterile delivery Not recommended Optional Recommended ( Ampicillin and Gentamicin ) Recommended Not recommended Not recommended Recommended ( Ampicillin and Gentamicin) Recommended มารดาได TT > 2 ครั งระหวางตั งครรภ และได last dose กอน คลอด > 1 เดอน ไม วาจะ Unsterile/ Sterile delivery มารดาไมมประวัต ได TT ระหวางตั งครรภ และ Sterile delivery Not recommended Not recommended Not recommended Recommended * เน่องจากตองคํานงถงเช อท่อาจทําใหเกด early onset neonatal sepsis ดังตอไปน คอ E. coli , GBS and L. monocytogenes ดวย เราจงควรให Antibiotics ใหครอบคลุมเช อเหลาน จนกวาพสูจนไดวาเป็นจาก Clostridium tetani จงสามารถเปล่ยนไปให Penicillin อยางเดยว (ในรายท่แพ penicillin อาจใช Metronidazole แทน) 40

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  • Tetanus Antitoxin , Tetanus Toxoid and Antibiotics

    tetanus antitoxin , tetanus toxoid , and antibiotics

    Tetanus Toxoid (TT)

    Tetanus Antitoxin (TAT)

    Antibiotics*

    CBC, Hemoculture

    and 3-5 day

    observation **

    TT Unsterile delivery

    Not recommended

    Optional Recommended ( Ampicillin and Gentamicin )

    Recommended

    Not recommended

    Not recommended

    Recommended ( Ampicillin and Gentamicin)

    Recommended

    TT > 2 last dose > 1 Unsterile/ Sterile delivery TT Sterile delivery

    Not recommended

    Not recommended

    Not recommended

    Recommended

    * early onset neonatal sepsis E. coli , GBS and L. monocytogenes Antibiotics Clostridium tetani Penicillin ( penicillin Metronidazole )

    40

  • 41

    ** incubation period Clostridum tetani Tetanus neonatorum 3 - 14 : 3 Unsterile cutting umbilical cord care umbilical stump Antiseptic solution 70% alcohol , povidone - iodine , triple dye solution umbilical stump open to air


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