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Vitamin C for preventing and treating tetanusHemilä H, Koivula T
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SummaryVitamin C for preventing and treating tetanusTetanus is a disease caused by tetanus toxin, which is produced by the bacterium Clostridium tetani. This bacterium typically infects penetrating wounds contaminated by foreign material such as soil. In developing countries, poor hygiene after childbirth may cause tetanus in newborn babies. Even though vaccination has dramatically decreased the burden of tetanus, there are still about one million cases per year globally. We found one controlled trial that examined whether 1 gram per day of intravenous vitamin C would help in the treatment of tetanus patients. Vitamin C was used alongside standard treatments for tetanus. Intravenous vitamin C reduced mortality of children aged between 1 and 12 with tetanus by 100% and mortality of 13 to 30 year old patients by 45%. The trial was not properly conducted and therefore great caution is required in the interpretation of the findings. Vitamin C cannot be recommended as a treatment for tetanus on the basis of this single study. Further investigation of the role of vitamin C in tetanus treatment is warranted.
This is a Cochrane review abstract and plain language summary, prepared and maintained by The Cochrane Collaboration, currently published in The Cochrane Database of Systematic Reviews 2010 Issue 1, Copyright © 2010 The Cochrane Collaboration. Published by John Wiley and Sons, Ltd.. The full text of the review is available in The Cochrane Library (ISSN 1464-780X).
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April 16. 2008 AbstractBackgroundTetanus is a severe infection that can be prevented by vaccination. In developing countries vaccination coverage is not always high and in developed countries cases may still occur, particularly in elderly people owing to their reduced immunoprotection. It has been estimated that there are about one million cases of tetanus per year globally. In animal studies, vitamin C protected against various infections. In a study with rats, vitamin C protected against tetanus toxin. ObjectivesTo assess the prophylactic and therapeutic effect of vitamin C in tetanus. Search strategyWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, 2007, issue 4), MEDLINE (1950 to January 2008), EMBASE (1980 to 2008 Week 03), the Cochrane Wounds Group Specialised Register (January 2008), the Cochrane Infectious Diseases Group Specialised Register (June 2007), and the reference lists of relevant reviews and monographs. Selection criteriaWe included controlled trials of vitamin C as a prevention or treatment for tetanus, whether or not placebo controlled, in any language, published or unpublished. Two authors independently made inclusion decisions. Data collection and analysisBoth review authors independently extracted data from trial reports. Main resultsOne single trial was eligible for inclusion. This non randomised, controlled, unblinded treatment trial involved 117 tetanus patients and was undertaken in Bangladesh. Vitamin C at a dosage of 1 g/day was administered intravenously alongside conventional treatment. At recruitment, the participants were stratified into two age groups and the results were reported by age. In the children aged 1 to 12 years (n = 62), vitamin C treatment was associated with a 100% reduction in tetanus mortality (95% confidence interval from -100% to -94%). In people aged 13 to 30 years (n = 55), vitamin C treatment was associated with a 45% reduction in tetanus mortality (95% confidence interval from -69% to -5%). Authors' conclusionsA single, non randomised, poorly reported trial of vitamin C as a treatment for tetanus suggests a considerable reduction in mortality. However, concerns about trial quality mean that this result must be interpreted with caution and vitamin C cannot be recommended as a treatment for tetanus on the basis of this evidence. New trials should be carried out to examine the effect of vitamin C on tetanus treatment. |