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.com
Volume 6
Journal of Infectious Diseases and Therapy
ISSN: 2332-0877
Infection Congress 2018
March 01-02, 2018
March 01-02, 2018 Berlin, Germany
5
th
International Congress on
INFECTIOUS DISEASES
Magnesium in tetanus: A systematic review of the literature 1980-2017
Catherine Hsu
and
Su Ling Yeoh
Cambridge University School of Clinical Medicine, UK
T
etanus remains a dangerous problem in many low to middle-income countries, despite the availability of an effective
vaccine. Death usually arises from autonomic dysfunction and spasm-related respiratory failure. Heavy sedation with
benzodiazepines therefore forms the cornerstone of treatment. However, this necessitates mechanical ventilation, often
unavailable where tetanus burden is highest, and may explain why tetanus mortality has remained >40% in the last 50 years.
Magnesium sulphate has been suggested as a promising therapeutic alternative, but only one inconclusive meta-analysis has
been published on its use in tetanus. We therefore performed an up-to-date systematic literature review of all primary studies
examining the effects of magnesium sulphate on mortality, length of stay, spasm and autonomic control and potential toxicity
in tetanus patients. Two independent reviewers carried out a set search on PubMed and Web of Knowledge. Identified texts
underwent abstract and full text review, with further review of relevant reference lists. Data was then extracted for comparison.
No study showed a mortality benefit. However, magnesium was demonstrated to significantly shorten duration of hospital stay,
reduce muscle spasms, lower maximum systolic blood pressure and heart rate, and reduce the need for additional drugs such as
benzodiazepines and inotropes. Magnesium at therapeutic serum levels was not associated with any clinically significant side
effect, though disagreement exists as to whether magnesium causes hypoventilation. Magnesium appears both safe and effective
in managing tetanus. Future work should establish regimens preserving respiratory muscle function, to allow widespread use
of magnesium in units without access to ventilatory support.
Biography
Catherine Hsu is final-year medical students at the University of Cambridge with an interest in infectious disease medicine and global health. They undertook their
elective at the Oxford University Clinical Research Unit (OUCRU) in Vietnam, under the guidance of Dr Louise Thwaites (senior clinical research fellow and member
of the Emerging Infections group at OUCRU). Catherine completed a BA researching the oncogenic potential of human herpesvirus-8 and has also presented her
work on neglected tropical diseases at a national level. Su Ling completed her BA in neuroscience and is particularly interested in neurological infections.
cth.hsu@gmail.comCatherine Hsu et al., J Infect Dis Ther 2018, Volume 6
DOI: 10.4172/2332-0877-C1-039