Treatment of Neonatal Tetanus with High Dosage Diazepam

  • Tjut Dharmawati Department of Child Health, Universitas Sumatera Utara Medical School/Dr. Pirngadi General Hospital, Medan, North Sumatera
  • Fauzi Rizal Department of Child Health, Universitas Sumatera Utara Medical School/Dr. Pirngadi General Hospital, Medan, North Sumatera
  • Munar Lubis Department of Child Health, Universitas Sumatera Utara Medical School/Dr. Pirngadi General Hospital, Medan, North Sumatera
  • Chairul Yoel Department of Child Health, Universitas Sumatera Utara Medical School/Dr. Pirngadi General Hospital, Medan, North Sumatera
  • Syahril Pasaribu Department of Child Health, Universitas Sumatera Utara Medical School/Dr. Pirngadi General Hospital, Medan, North Sumatera
  • Chairuddin P. Lubis Department of Child Health, Universitas Sumatera Utara Medical School/Dr. Pirngadi General Hospital, Medan, North Sumatera
DOI: https://doi.org/10.14238/pi33.3-4.1993.71-6
Keywords: neonatal tetanus; diazepam; incubation; bronchopneumonia; endotracheal intubation

Abstract

A retrospective study on neonatal tetanus, among patients hospitalized at the pediatric ward of Dr. Pirngadi Hospital Medan, bad been conducted from january 1987 through December 1991. There were 75 cases out of 13,581 patients hospitalized (0.55%) in that period, consisting of 44 boys (58.66%) and31 girls (47 3 %) with an overall case fatality rate of 33.33%.

Of 18 patients with an incubation period of 5 days or less, 12 (66.66%) died, while of 4 patients with an incubation period of more than 10 days, there were not any death at all. Diazepam had been given in a dosage of 10-40 mg/kg body weight/day . Diazepam of 10-19 mg/kg body weight/day was given to 4 cases, and the case fatality rate was 25% . Of 42 cases treated with diazepam of 30-40 mg/kg body weight/day, the case fatality rate was 42.85% The duration of hospitalization varied between ten hours to 34 days. All deaths (25 cases) occurred within the first seven days of hospitaltization. The most common accompanying disease was bronchopneumonia (6 cases). Endotracheal intubation were performed on 11 cases, while the mechanical ventilator in 1 case with a case fataliy rate of 27,27% and 0% respectively.

References

1. Lubis CP, Pasaribu S and Lubis M. Morbidity of tetanus diphtheria and morbili case (A 1982 - 1985 study at the child health department) Dr. Pirngadi Hospital Medan J. of Singapore Pediat Society, 1987; 29 SUPP : 66 - 77 .
2. Fahmi H, Wardi, Winarti, Djoko A, Akbar A. Kematian tetanus neonatorum di Lombok Tengah & Lombok Timur. Medika 1990; 6 : 445 - 51 .
3. Soetomenggolo TS, Purboyo PH, Hendarto SK and lsmael S. Neonatal tetanus treated with diazepam as single anti spasmodic agent. Pediatr. Inclones; 1981; 21 : 101 - 6.
4. Sugitha N, Suwendra P and Suraatrnaja S. High Dosage diazepam single anti spasmodic agent in the treatment of neonatal tetanus. Pediatr Inclones 1982; 23 : 163- 72.
5. Lubis CP . Tetanus neonatorum. Diktat kuliah llmu Kesehatan Anak; Penyakit lnfeksi Bagian II (BP FK UNIVERITAS SUMATERA UTARA- 39).
6. Sumarto and Budiman D . Valium on the treatment of tetanus neonatorum. Pediatr Indones ; 1979 : 221 - 28 .
7. Arnan IGM . Farrnakokinetik benzo diazepam. Medika 1986; 9 : 865 - 70 .
8. Husada TJ, Munir M. Neonatal tetanus, analysis of 108 cases using a scoring system. Pediatr Inclones
1978; 18 : 263- 68.
9. Ismudijanto, Koeswardoyo, Soejono DA, Sugijanto S, Kaplan MF, Ranuh IGNG . Diazepam dosis tinggi pada tetanus neonatorum. Diajukan pada Kongres Nasional Jlmu Kesehatan Anak (KONIKA) V Medan (1981) .
10. Krugman S and Katz SL Tetanus (Lock Jaw) in Krugman S and Katz SL . Infectious diseases of children. Seventh Edition, St. Louis Mosby; 1981 : 413- 4 .
11. Rampengan TH, Mustajab I, Pairunan JR and Rampengan Ny. Studi pembangunan penggunaan Diazepam rektal & i/v pada tetanus neonatorum. Majalah Kedokteran Tropis, Ind; 1987; 2: 3-8.
12. Daili S, Yahya E & Asnil PO . Valium as anti convulsant in tetanus. Pediatr Indones 1972; 12 : 229- 34 .
13. Hassan R. Pengobatan tetanus neonatorum dengan ventilator mekhanik. Medika, 1982; 3 : 179 -82 .
Published
2018-12-12
How to Cite
1.
Dharmawati T, Rizal F, Lubis M, Yoel C, Pasaribu S, Lubis C. Treatment of Neonatal Tetanus with High Dosage Diazepam. PI [Internet]. 12Dec.2018 [cited 20Nov.2024];33(3-4):71-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2064
Issue
Vol 33 No 3-4 (1993): March - April 1993
Section
Pediatric Neurology

Copyright (c) 2018 Tjut Dharmawati, Fauzi Rizal, Munar Lubis, Chairul Yoel, Syahril Pasaribu, Chairuddin P. Lubis

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Authors who publish with this journal agree to the following terms:

Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

Received 2018-12-12
Published 2018-12-12