According to age, the elevation of the tetanus antibody titer after tetanus prophylaxis might be not equivalent because of different levels of basal immunity and the time-interval of the last tetanus vaccination. The formation of tetanus antibody after tetanus vaccination is not influenced by TIG at the late period and in adults below the age of 50 yr, but you will find significant differences between the two groups at the early period of 4 weeks after vaccination and for the patients over 60 yr. Keywords:Tetanus, Tetanus Toxoid, Immunoglobulins == INTRODUCTION == Despite efforts paid by the World Health Business and the government of developing countries, tetanus persists as a global health problem. Tetanus prophylaxis after injury had been launched in US Immunization Practices Advisory Committee (ACIP) guideline and this guideline has been used in emergency departments (EDs) (1). However, some studies have shown that physician compliance with the guideline for tetanus prophylaxis according to the past vaccination history and the kind of wound is very low and their decisions were sometimes incorrect (2-4). The reasons for physician noncompliance with the ACIP guideline are likely due to a lack of familiarity with the guideline or failure to document the appropriate history (3). In a busy and overcrowded ED, many emergency physicians are unable to get Eperezolid sufficient medical information of patients on the past tetanus vaccination history and individual immunity. When an hurt patient visits the ED, unnecessary injection of tetanus immunoglobulin (TIG) may cause side effects and also increase the medical expense (5). Further, the opportunity of assessing a rising tetanus antibody titer may be missed after simultaneous injection of tetanus-diphtheria vaccine (Td) and TIG. According to age, the elevation of the tetanus antibody titer after tetanus prophylaxis might be not equivalent because of different levels of basal immunity and the time-interval of the last tetanus vaccination. Therefore, we wanted to determine whether TIG influences the level of tetanus antibody after simultaneous tetanus vaccination according to age and the time-interval of the Eperezolid last tetanus vaccination. == MATERIALS AND METHODS == == Vaccine and immunoglobulin == Tetanus and diphtheria toxoid vaccine (Td-pur, Norvatis, Marburg, Germany) and tetanus immunoglobulin (Hypertet; Green Cross, Seoul, Korea) were used in this study. The Td vaccine was the licensed formulation that has been utilized for over 5 yr and it contains not less than 20 international unit (IU) per 0.5 mL dose. TIG has anti-tetanus human immunoglobulin 250 IU per 1 mL. == Participants == A total of 237 healthy adult volunteers who were over 20 yr aged were enrolled and immunized in one emergency center of an academic teaching hospital. All the participants made lists of answers to questionnaire about the variables of age, gender, previous vaccination or a prophylaxis history, and military support. == Study design and procedures == This study was a randomized, controlled clinical trial. The participants were divided into different age groups: twenties (20-29 yr), thirties (30-39 yr), Eperezolid forties (40-49 yr), fifties (50-59 yr) and over sixty (60 yr). Some of the subjects, typically those in their twenties, already experienced high tetanus titers on account of previous tetanus at the beginning of military support, and a relatively short time-interval from your last child vaccination, and those subjects who had a high or adequate tetanus antibody titer might be disaffiliated in the case of a positive result after a field examination with a tetanus quick Rabbit Polyclonal to FST stick (TQS). The TQS is usually semiquantitative test of the tetanus antibody by using immunochromatography. The detection threshold asserted by the manufacturer is usually 0.2 international units (IU)/mL in the whole blood. For each age, all the subjects were allocated into two groups by using a computer-generated list of random figures. Group 1 was composed of the subjects who had a single injection of Td vaccine and Group 2 was composed of the subjects who experienced a simultaneous injection of Td vaccine plus TIG. Blood samples (3 mL) were obtained just before and at 4 weeks, 6 months and 12 months after immunization, respectively. All the blood samples were centrifuged and serum was separated immediately, and stored at -70. == Serological assays == The tetanus antibody Eperezolid titers were determined by enzyme-linked immunosorbent assay (ELISA kit; Novalisa, NovaTec, Dietzenbach, Germany) in accordance with the manufacturer’s recommendation. The results were reported in IU/mL, and they were standardized by comparing them to calibrated World Health Business (WHO) reference sera. The cutoff of these positive results was 0.1 IU/mL. == Statistical analysis.
