A 7-day-old exclusively breastfed neonate delivered at home presents with inability to feed, trismus, and episodic generalized spasms triggered by touch. There is a foul-smelling dressing applied to the umbilical stump. Which drug forms part of definitive management alongside antitetanus immunoglobulin?
- A Metronidazole ✓
- B Gentamicin
- C Amoxicillin
- D Naloxone
Correct answer: A. Metronidazole
Explanation
Neonatal tetanus follows contamination of the umbilical stump, classically with unsterile dressings in home deliveries. Clostridium tetani toxin blocks inhibitory neurotransmitter release causing rigidity and spasms. Metronidazole is the antibiotic of choice against the vegetative organisms, along with human tetanus immunoglobulin, diazepam for spasms, wound debridement, and supportive care. Penicillin is an acceptable alternative but gentamicin and amoxicillin lack efficacy against anaerobes.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.