Materiały źródłowe

• #1 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/rr/rr7002a1.htm

  Botulism is a rare, neurotoxin-mediated, life-threatening disease characterized by flaccid descending paralysis that begins with cranial nerve palsies and might progress to extremity weakness and respiratory failure. […] Treatment involves supportive care, intubation and mechanical ventilation when necessary, and administration of botulinum antitoxin. […] Before the publication of these guidelines, no comprehensive clinical care guidelines existed for treating botulism. […] The recommendations in these guidelines address the conventional standard of care, in which medical resources are not limited, as well as settings of contingency and crisis standards of care, with limited medical resources. […] The only specific therapy for botulism is botulinum antitoxin. […] When administered early in the course of illness (within 48 hours of symptom onset and ideally within 24 hours), botulinum antitoxin can stop the progression of paralysis and prevent respiratory compromise in certain patients.

• #1 Botulism – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266

  For cases of foodborne botulism, health care providers sometimes clear out the digestive system by causing vomiting and giving drugs to help you move your bowels. If you have wound botulism, a provider may need to remove infected tissue in a surgery. […] If you’re diagnosed early with foodborne or wound botulism, injected antitoxin lowers the risk of complications. The antitoxin attaches itself to toxin that’s moving through your bloodstream and keeps it from harming your nerves. […] The antitoxin can’t reverse damage that’s already been done. But nerves can repair themselves. Many people recover fully. But recovery may take months and typically involves extended rehabilitation therapy. […] Antibiotics are recommended for the treatment of wound botulism. These drugs aren’t used for other forms of botulism because they can speed up the release of toxins.

• #2

  https://www.who.int/news-room/fact-sheets/detail/botulism

  Antitoxin should be administered as soon as possible after a clinical diagnosis. Early administration is effective in reducing mortality rates. […] Successful treatment depends significantly on early diagnosis and the rapid administration of the botulinum antitoxin.

• #2 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  Botulism is a rare but serious illness that attacks your bodys nervous system. […] Treatment typically includes antitoxin to prevent the toxin from causing more damage. […] Depending on the cause and severity of your botulism, your healthcare provider may use a variety of treatment options. In the most common treatment, your healthcare provider will give you a medication called an antitoxin. Antitoxins block the toxins activity in your bloodstream. This prevents the toxins from causing any more damage. But antitoxin cant heal whats already been damaged. You may need to stay in the hospital for weeks or months while you heal. […] If you have breathing problems, your healthcare provider may place you on a breathing machine (ventilator). A ventilator is a machine that helps you breathe. Youll be on a ventilator until any paralysis affecting your breathing goes away.

• #2 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/rr/rr7002a1.htm

  Administer botulinum antitoxin to patients with suspected botulism as early as possible in the course of illness. […] Patients with suspected botulism whose symptoms or signs (e.g., paralysis) are progressing should be treated with BAT regardless of the time that has elapsed since symptom onset. […] Evidence does not indicate benefit from any treatment modalities other than antitoxin, although data are limited.

• #2 Botulism – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266

  For cases of foodborne botulism, health care providers sometimes clear out the digestive system by causing vomiting and giving drugs to help you move your bowels. If you have wound botulism, a provider may need to remove infected tissue in a surgery. […] If you’re diagnosed early with foodborne or wound botulism, injected antitoxin lowers the risk of complications. The antitoxin attaches itself to toxin that’s moving through your bloodstream and keeps it from harming your nerves. […] The antitoxin can’t reverse damage that’s already been done. But nerves can repair themselves. Many people recover fully. But recovery may take months and typically involves extended rehabilitation therapy. […] Antibiotics are recommended for the treatment of wound botulism. These drugs aren’t used for other forms of botulism because they can speed up the release of toxins.

• #3 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  It is essential to administer botulinum antitoxin promptly based on clinical findings without waiting for laboratory confirmation, as administering the treatment within the first 2 days of symptom onset offers the most significant benefit. […] Healthcare providers also should consider the possibility of botulism in pregnant patients and treat them with the same urgency and protocols as nonpregnant patients. […] Additionally, it is crucial to provide comprehensive support that addresses both the physical and psychological impacts of the illness on patients and their families. […] Finally, proactive planning for potential antitoxin shortages is necessary, ensuring that effective systems are in place to manage such crises efficiently. […] On March 22, 2013, the FDA approved the first botulism antitoxin that can neutralize all 7 known botulinum nerve toxin serotypes. […] The heptavalent antitoxin is derived from horse plasma and is the only drug available for treating botulism in patients older than 1 year, including adults. […] It also is the only available drug for treating infant botulism that is not caused by nerve toxin type A or B; otherwise, human-origin anti-A, anti-B botulinum antitoxin (BabyBIG) should be obtained from the California Infant Botulism Treatment and Prevention Program at +1 510-231-7600 (do not use equine antitoxin for infants).

• #4 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8112830/

  When administered early in the course of illness (within 48 hours of symptom onset and ideally within 24 hours), botulinum antitoxin can stop the progression of paralysis and prevent respiratory compromise in certain patients. […] Health care providers who suspect botulism on the basis of clinical symptoms should immediately call the emergency contact number of their local or state health department to arrange for an emergency clinical consultation and, when indicated, shipment of antitoxin. […] Administer botulinum antitoxin to patients with suspected botulism as early as possible in the course of illness. […] Patients with suspected botulism whose symptoms or signs (e.g., paralysis) are progressing should be treated with BAT regardless of the time that has elapsed since symptom onset. […] Patients with suspected botulism should be treated with BAT regardless of underlying medical conditions or age, sex, or other demographic characteristics.

• #5 Botulism – Wikipedia

  https://en.wikipedia.org/wiki/Botulism

  In adults, a trivalent antitoxin containing antibodies raised against botulinum toxin types A, B, and E is used most commonly; however, a heptavalent botulism antitoxin has also been developed and was approved by the U.S. FDA in 2013. […] In infants, horse-derived antitoxin is sometimes avoided for fear of infants developing serum sickness or lasting hypersensitivity to horse-derived proteins. To avoid this, a human-derived antitoxin has been developed and approved by the U.S. FDA in 2003 for the treatment of infant botulism. This human-derived antitoxin has been shown to be both safe and effective for the treatment of infant botulism.

• #6 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Antitoxin therapy available to healthcare professionals currently exists in 2 forms: heptavalent equine serum antitoxin, indicated for patients older than 1 year, and human-derived immunoglobulin, indicated for infants younger than 1 year. […] The administration of antitoxin will not reverse neurological paralysis, given that BoNT binds irreversibly, but it will help stop disease progression. […] For wound botulism, debridement and antibiotic therapy are indicated following antitoxin administration. […] Close monitoring should include frequent clinical evaluation of ventilation, perfusion, upper airway integrity, continuous pulse oximetry, spirometry, and arterial blood gas measurement. […] Aggressive supportive care in an intensive care unit setting is recommended.

• #7 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/ObtainBabyBig.aspx

  The mission of the IBTPP is to provide and improve the treatment of infant botulism and to prevent infant botulism and related diseases. […] The decision to treat with BabyBIG should be based on clinical presentation and findings and should not be delayed by waiting for results of laboratory confirmatory testing. Prompt treatment of infant botulism patients with BabyBIG immediately ends their toxemia and enables motor nerve regeneration to begin. […] BabyBIG, Botulism Immune Globulin Intravenous (Human) (BIG-IV), is an orphan drug that consists of human-derived anti-botulism-toxin antibodies that is approved by the U.S. Food and Drug Administration for the treatment of infant botulism types A and B. […] To date, use of BabyBIG to treat more than 2,180 US infant botulism patients has resulted in more than 128 years of avoided hospital stay and more than $174 million of avoided hospital costs. On average, infant botulism patients have an approximately 3.6 week reduction in time spent in the hospital, resulting in over $94,000 in avoided hospital costs (when compared to the pivotal clinical trial placebo group).

• #8 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  It is essential to administer botulinum antitoxin promptly based on clinical findings without waiting for laboratory confirmation, as administering the treatment within the first 2 days of symptom onset offers the most significant benefit. […] Healthcare providers also should consider the possibility of botulism in pregnant patients and treat them with the same urgency and protocols as nonpregnant patients. […] Additionally, it is crucial to provide comprehensive support that addresses both the physical and psychological impacts of the illness on patients and their families. […] Finally, proactive planning for potential antitoxin shortages is necessary, ensuring that effective systems are in place to manage such crises efficiently. […] On March 22, 2013, the FDA approved the first botulism antitoxin that can neutralize all 7 known botulinum nerve toxin serotypes. […] The heptavalent antitoxin is derived from horse plasma and is the only drug available for treating botulism in patients older than 1 year, including adults. […] It also is the only available drug for treating infant botulism that is not caused by nerve toxin type A or B; otherwise, human-origin anti-A, anti-B botulinum antitoxin (BabyBIG) should be obtained from the California Infant Botulism Treatment and Prevention Program at +1 510-231-7600 (do not use equine antitoxin for infants).

• #9 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  Botulism is a rare but serious illness that attacks your bodys nervous system. […] Treatment typically includes antitoxin to prevent the toxin from causing more damage. […] Depending on the cause and severity of your botulism, your healthcare provider may use a variety of treatment options. In the most common treatment, your healthcare provider will give you a medication called an antitoxin. Antitoxins block the toxins activity in your bloodstream. This prevents the toxins from causing any more damage. But antitoxin cant heal whats already been damaged. You may need to stay in the hospital for weeks or months while you heal. […] If you have breathing problems, your healthcare provider may place you on a breathing machine (ventilator). A ventilator is a machine that helps you breathe. Youll be on a ventilator until any paralysis affecting your breathing goes away.

• #10 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Antitoxin therapy available to healthcare professionals currently exists in 2 forms: heptavalent equine serum antitoxin, indicated for patients older than 1 year, and human-derived immunoglobulin, indicated for infants younger than 1 year. […] The administration of antitoxin will not reverse neurological paralysis, given that BoNT binds irreversibly, but it will help stop disease progression. […] For wound botulism, debridement and antibiotic therapy are indicated following antitoxin administration. […] Close monitoring should include frequent clinical evaluation of ventilation, perfusion, upper airway integrity, continuous pulse oximetry, spirometry, and arterial blood gas measurement. […] Aggressive supportive care in an intensive care unit setting is recommended.

• #11 Foodborne Botulism: Clinical Diagnosis and Medical Treatment

  https://www.mdpi.com/2072-6651/12/8/509

  As a general approach, antitoxin should be administered as soon as suspect of botulism intoxication is made. […] Some clinical experience confirmed that the early administration of antitoxin (within 24 h), is more effective in preventing the progression of neurological syndrome and in shortening the duration of mechanical ventilation and intensive care stay. […] The safety and improved clinical outcomes was evaluated in patients treated with BAT during the Investigational New Drug (“compassionate use” IND) study period (2010–2013). […] The diagnosis of botulism is essentially clinical even if the role of the laboratory permits to confirm the clinical diagnosis, to identify the different BoNTs involved and eventually the source. […] The treatment of botulism includes (i) gastrointestinal decontamination (if indicated), (ii) antidote (antitoxin) and (iii) eventually respiratory support.

• #12 Foodborne Botulism: Clinical Diagnosis and Medical Treatment

  https://www.mdpi.com/2072-6651/12/8/509

  As a general approach, antitoxin should be administered as soon as suspect of botulism intoxication is made. […] Some clinical experience confirmed that the early administration of antitoxin (within 24 h), is more effective in preventing the progression of neurological syndrome and in shortening the duration of mechanical ventilation and intensive care stay. […] The safety and improved clinical outcomes was evaluated in patients treated with BAT during the Investigational New Drug (“compassionate use” IND) study period (2010–2013). […] The diagnosis of botulism is essentially clinical even if the role of the laboratory permits to confirm the clinical diagnosis, to identify the different BoNTs involved and eventually the source. […] The treatment of botulism includes (i) gastrointestinal decontamination (if indicated), (ii) antidote (antitoxin) and (iii) eventually respiratory support.

• #13 Botulism – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266

  If you’re having trouble breathing, you probably need a mechanical ventilator for up to several weeks while your body fights the toxin’s effects. The ventilator forces air into your lungs through a tube inserted in your airway through your nose or mouth. […] As you recover, you may also need therapy to improve your speech, swallowing and other functions affected by botulism.

• #14 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  Botulism is a rare but serious illness that attacks your bodys nervous system. […] Treatment typically includes antitoxin to prevent the toxin from causing more damage. […] Depending on the cause and severity of your botulism, your healthcare provider may use a variety of treatment options. In the most common treatment, your healthcare provider will give you a medication called an antitoxin. Antitoxins block the toxins activity in your bloodstream. This prevents the toxins from causing any more damage. But antitoxin cant heal whats already been damaged. You may need to stay in the hospital for weeks or months while you heal. […] If you have breathing problems, your healthcare provider may place you on a breathing machine (ventilator). A ventilator is a machine that helps you breathe. Youll be on a ventilator until any paralysis affecting your breathing goes away.

• #15 Botulism

  https://www.nhs.uk/conditions/botulism/

  Botulism needs to be treated in hospital. […] The way it’s treated depends on the type of botulism, but usually involves: neutralising the toxins with injections of special antitoxins or antibodies, supporting the functions of the body, such as breathing, until you recover. […] Treatment will not immediately reverse any paralysis that’s already been caused by the toxin, but will stop it getting any worse. […] In most people, paralysis that occurred before treatment will gradually improve over the following weeks or months.

• #16 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Botulism is a rare but life-threatening neuroparalytic syndrome caused by the botulinum neurotoxin, most often produced by the bacterium Clostridium botulinum. […] Prompt administration of botulinum antitoxin and supportive care is essential, though recovery can take months to years. […] The administration of polyvalent antitoxin to BoNT mitigates the clinical course of botulism. However, no true antidote exists, and disease management relies on potentially weeks of mechanical ventilation and other resource-heavy therapies while the body’s neuromuscular signaling mechanisms recover. […] Treatment of botulism consists of antitoxin administration, hospital admission, close monitoring, respiratory support as required, and debridement with antibiotic coverage in the case of wound botulism.

• #17 What is the treatment of botulism? | The Faculty of Intensive Care Medicine

  https://www.ficm.ac.uk/documents/what-is-the-treatment-of-botulism

  What is the treatment of botulism? […] Treatment with Penicillin G is recommended for wound botulism. […] Antitoxin can reduce severity of symptoms if given early, but will not reverse paralysis. […] A Forced Vital Capacity of below 12ml/kg has been suggested as an indication for mechanical ventilation. […] Early input from microbiology and infectious disease specialists is recommended.

• #18 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Antitoxin therapy available to healthcare professionals currently exists in 2 forms: heptavalent equine serum antitoxin, indicated for patients older than 1 year, and human-derived immunoglobulin, indicated for infants younger than 1 year. […] The administration of antitoxin will not reverse neurological paralysis, given that BoNT binds irreversibly, but it will help stop disease progression. […] For wound botulism, debridement and antibiotic therapy are indicated following antitoxin administration. […] Close monitoring should include frequent clinical evaluation of ventilation, perfusion, upper airway integrity, continuous pulse oximetry, spirometry, and arterial blood gas measurement. […] Aggressive supportive care in an intensive care unit setting is recommended.

• #19 Botulism – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266

  For cases of foodborne botulism, health care providers sometimes clear out the digestive system by causing vomiting and giving drugs to help you move your bowels. If you have wound botulism, a provider may need to remove infected tissue in a surgery. […] If you’re diagnosed early with foodborne or wound botulism, injected antitoxin lowers the risk of complications. The antitoxin attaches itself to toxin that’s moving through your bloodstream and keeps it from harming your nerves. […] The antitoxin can’t reverse damage that’s already been done. But nerves can repair themselves. Many people recover fully. But recovery may take months and typically involves extended rehabilitation therapy. […] Antibiotics are recommended for the treatment of wound botulism. These drugs aren’t used for other forms of botulism because they can speed up the release of toxins.

• #20 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  If you have wound botulism, you may need an operation to remove the contaminated part of your wound surgically. After the operation, you may take antibiotics to keep the infection from coming back. […] No specific treatment will cure botulism, though mild nerve damage can heal. Antitoxins can stop further damage from the toxin. […] Botulism can paralyze the muscles that help you swallow and breathe. While antitoxins can help in many cases, some people do die of breathing problems and infections. […] Depending on the severity of your case, recovery from botulism can take weeks, months or even years. Most people who receive prompt treatment recover completely in fewer than two weeks.

• #21 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  Wound botulism requires incision and thorough debridement of the infected wound, antitoxin therapy, and antibiotics should be provided as clinically indicated. […] Consultations with an infectious diseases specialist and a neurologist frequently are beneficial. […] A nutritionist should be consulted for hyperalimentation and tube-feeding recommendations and monitoring. […] Physical and occupational therapists are needed to work on range-of-motion exercises and assisted ambulation, as tolerated. […] Nasogastric suction and intravenous hyperalimentation are important when an ileus is present. […] If no ileus is present or when the ileus resolves, tube feeding can be used for nutritional supplementation. […] Bedrest initially is required. […] Increase activity as tolerated.

• #22 Botulism Medication: Antibiotics, Nitroimidazoles, Antitoxins

  https://emedicine.medscape.com/article/213311-medication

  Antibiotics are useful in wound botulism, but they have no role in foodborne botulism. […] When botulism develops following a wound infection, antibiotic therapy and meticulous debridement of the wound are essential. […] These agents are essential in the treatment of foodborne botulism and wound botulism. Heptavalent antitoxin (toxins A through G) is available at the Centers for Disease Control and Prevention (CDC). […] Antitoxin indicated for naturally occurring noninfant botulism. Equine-derived antitoxin that elicits passive antibody (ie, immediate immunity) against Clostridium botulinum toxins A, B, C, D, E, F, and G.

• #23 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Botulism is a rare but life-threatening neuroparalytic syndrome caused by the botulinum neurotoxin, most often produced by the bacterium Clostridium botulinum. […] Prompt administration of botulinum antitoxin and supportive care is essential, though recovery can take months to years. […] The administration of polyvalent antitoxin to BoNT mitigates the clinical course of botulism. However, no true antidote exists, and disease management relies on potentially weeks of mechanical ventilation and other resource-heavy therapies while the body’s neuromuscular signaling mechanisms recover. […] Treatment of botulism consists of antitoxin administration, hospital admission, close monitoring, respiratory support as required, and debridement with antibiotic coverage in the case of wound botulism.

• #24 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Botulism-Treatment-and-Prevention.aspx

  The standard of care for treating botulism is administration of antitoxin. It binds directly with the bacterial toxin and prevents it from causing more damage to the nervous system. However, the drug cannot heal the damage already done by the toxins. The mortality rates can be significantly reduced with an immediate antitoxin treatment. In infants, botulism is treated with an antitoxin called botulism immune globulin. […] In wound botulism, surgery may be necessary to remove the affected tissue. Antibiotics may be indicated to limit growth of botulism and other co-infecting bacteria in wounds. However, antibiotics are not recommended for other botulism types because these medicines can increase the rate of toxin release. […] If the botulism is associated with breathing difficulties, a mechanical ventilator may be used to help the patient breath normally until the severity of symptoms reduces gradually. After completion of the treatment, people who present with fatigue, speech problems, shortness of breath, and swallowing difficulties may need long-term rehabilitation for months or years to recover.

• #25 Botulism – Diagnosis & Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/botulism-diagnosis-treatment/

  Botulism is a rare, potentially fatal disease caused by the toxin produced by Clostridium botulinum spores – a bacteria found in soil and honey, and on fruits, vegetables, meats, and fish. […] The treatment approach for all patients with botulism includes: Administration of botulism antitoxin heptavalent (BAT) as soon as possible after diagnosing botulism. Botulinum antitoxin binds to circulating botulinum toxins A to G to prevent the condition from getting worse but cannot reverse paralysis, thus, early administration is critical. […] Human-derived botulism immune globulin (BabyBIG) is indicated in infant botulism caused by botulinum toxins A or B, rather than BAT. […] Antibiotics are not recommended for infant botulism or adults with suspected gastrointestinal botulism because they could increase the amount of toxin. […] All patients with clinical findings suggestive of botulism should be hospitalized and monitored closely for signs of respiratory failure.

• #26 Botulism – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266

  For cases of foodborne botulism, health care providers sometimes clear out the digestive system by causing vomiting and giving drugs to help you move your bowels. If you have wound botulism, a provider may need to remove infected tissue in a surgery. […] If you’re diagnosed early with foodborne or wound botulism, injected antitoxin lowers the risk of complications. The antitoxin attaches itself to toxin that’s moving through your bloodstream and keeps it from harming your nerves. […] The antitoxin can’t reverse damage that’s already been done. But nerves can repair themselves. Many people recover fully. But recovery may take months and typically involves extended rehabilitation therapy. […] Antibiotics are recommended for the treatment of wound botulism. These drugs aren’t used for other forms of botulism because they can speed up the release of toxins.

• #27

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/botulism.aspx

  Public health priority: Urgent. […] PHU response time: Respond to suspected and confirmed cases immediately. Enter confirmed cases on NCIMS within 1 working day. […] Case management: Notify the Communicable Diseases Branch. Identify suspect foods if possible and test for toxin. […] Purging with cathartics, gastric lavage and high enemas may be indicated. […] Treatment of suspected cases of foodborne or wound botulism with botulinum antitoxin (BAT) should be commenced urgently. Immediate administration of antitoxin is the key to successful therapy, because antitoxin arrests the progression of paralysis. […] As botulinum neurotoxin binds irreversibly, administration of antitoxin does not reverse the paralysis but will help stop disease progression. […] Requests for emergency access to the small stockpile of equine-derived intravenous heptavalent botulinum antitoxin (BAT, Cangene Corporation) for the treatment of botulism should be directed to the NSW Health CDONCALL officer.

• #28 Foodborne Botulism: Clinical Diagnosis and Medical Treatment

  https://www.mdpi.com/2072-6651/12/8/509

  Botulinum neurotoxins (BoNTs) produced by Clostridia species are the most potent identified natural toxins. […] The treatment includes procedures for decontamination, antidote administration and, when required, support of respiratory function; few differences are related to the different way of exposure. […] Key points in the treatment of botulism are (i) the decontamination, (ii) the administration of the specific antidote and (iii) the support of respiratory function if necessary. There are only few differences related to the way of exposure. […] Once excluded eventually contraindications, gastrointestinal decontamination should be performed in all case of foodborne botulism, in order to remove the spores and toxin from the gut. […] The main goal of the antitoxin treatment is to neutralize the free circulating toxins still unbound at presynaptic level of nerve endings.

• #29 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/

  Infant botulism is a novel form of human botulism in which ingested spores of the bacterium Clostridium botulinum colonize and grow in the infant’s large intestine and produce botulinum neurotoxin in it. […] However, in the absence of complications, patients recover completely from the disease. […] After fellowship, Steve founded what would become the Infant Botulism Treatment and Prevention Program (IBTPP), a unit of the California Department of Public Health (CDPH). […] His relentless efforts to alert the public to avoid feeding honey to infants were joined internationally by pediatric and public health authorities, eventually resulting in voluntary labelling of commercial honey in the US. […] It has been distributed to all 50 United States and worldwide to treat over 3,000 infants to date.

• #30 Infant Botulism – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/infant-botulism

  Infant botulism results from ingestion of Clostridium botulinum spores, their colonization of the large intestine, and toxin production in vivo. […] Treatment is with support and human botulism immune globulin. […] Treatment of infant botulism is started as soon as the diagnosis is suspected; waiting for confirmatory test results, which may take days, is dangerous. […] Specific treatment of infant botulism is with human botulism immune globulin (BabyBIG), which is available from the Infant Botulism Treatment and Prevention Program (IBTPPcall 510-231-7600 or visit the IBTPP web site). […] The dose of human botulinum immune globulin is 50 mg/kg IV, given slowly. […] The horse serum heptavalent antitoxin used in adults is not recommended for infants. […] Antibiotics are not given because they may lyse C. botulinum in the gut and increase toxin availability.

• #31 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/ObtainBabyBig.aspx

  The mission of the IBTPP is to provide and improve the treatment of infant botulism and to prevent infant botulism and related diseases. […] The decision to treat with BabyBIG should be based on clinical presentation and findings and should not be delayed by waiting for results of laboratory confirmatory testing. Prompt treatment of infant botulism patients with BabyBIG immediately ends their toxemia and enables motor nerve regeneration to begin. […] BabyBIG, Botulism Immune Globulin Intravenous (Human) (BIG-IV), is an orphan drug that consists of human-derived anti-botulism-toxin antibodies that is approved by the U.S. Food and Drug Administration for the treatment of infant botulism types A and B. […] To date, use of BabyBIG to treat more than 2,180 US infant botulism patients has resulted in more than 128 years of avoided hospital stay and more than $174 million of avoided hospital costs. On average, infant botulism patients have an approximately 3.6 week reduction in time spent in the hospital, resulting in over $94,000 in avoided hospital costs (when compared to the pivotal clinical trial placebo group).

• #32 Infant Botulism – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/infant-botulism

  Infant botulism results from ingestion of Clostridium botulinum spores, their colonization of the large intestine, and toxin production in vivo. […] Treatment is with support and human botulism immune globulin. […] Treatment of infant botulism is started as soon as the diagnosis is suspected; waiting for confirmatory test results, which may take days, is dangerous. […] Specific treatment of infant botulism is with human botulism immune globulin (BabyBIG), which is available from the Infant Botulism Treatment and Prevention Program (IBTPPcall 510-231-7600 or visit the IBTPP web site). […] The dose of human botulinum immune globulin is 50 mg/kg IV, given slowly. […] The horse serum heptavalent antitoxin used in adults is not recommended for infants. […] Antibiotics are not given because they may lyse C. botulinum in the gut and increase toxin availability.

• #33 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/pages/botulism.aspx

  Botulism is a rare but serious disease caused by a toxin (poison) that attacks the nervous system and causes paralysis. Anyone can get botulism. […] If you or someone you know has symptoms of botulism, call 911 or go to the emergency room immediately. […] Botulism is a very serious disease that can be deadly if not treated. If caught early, botulism can be treated with botulinum antitoxin, which blocks the toxin from causing more harm in the body. But the antitoxin can’t undo any muscle paralysis that has already happened, so it can take weeks or even months for a person to get better. A person with severe botulism may need help breathing and may need to be on a breathing machine (ventilator) for weeks with intensive medical care. […] Botulinum antitoxin for patients 15 months of age and older in California is available by working with the local public health department, CDPH, and the U.S. Centers for Disease Control and Prevention (CDC). If the diagnosis of botulism is suspected, healthcare providers can ask for the botulinum antitoxin through their local health department, which will work with CDPH and CDC to release the antitoxin. For infant botulism, healthcare providers should contact the CDPH Infant Botulism Treatment and Prevention Program to obtain the licensed human botulinum antitoxin, BabyBIG.

• #34 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/ObtainBabyBig.aspx

  The mission of the IBTPP is to provide and improve the treatment of infant botulism and to prevent infant botulism and related diseases. […] The decision to treat with BabyBIG should be based on clinical presentation and findings and should not be delayed by waiting for results of laboratory confirmatory testing. Prompt treatment of infant botulism patients with BabyBIG immediately ends their toxemia and enables motor nerve regeneration to begin. […] BabyBIG, Botulism Immune Globulin Intravenous (Human) (BIG-IV), is an orphan drug that consists of human-derived anti-botulism-toxin antibodies that is approved by the U.S. Food and Drug Administration for the treatment of infant botulism types A and B. […] To date, use of BabyBIG to treat more than 2,180 US infant botulism patients has resulted in more than 128 years of avoided hospital stay and more than $174 million of avoided hospital costs. On average, infant botulism patients have an approximately 3.6 week reduction in time spent in the hospital, resulting in over $94,000 in avoided hospital costs (when compared to the pivotal clinical trial placebo group).

• #35 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/

  BabyBIG is the standard of care for infant botulism and shortens hospital stay by an average of 3.5 weeks, resulting in an average decrease in hospital charges of approximately $88,900, per patient (J Pediatr 2018;193:172-7). […] Honoring his incredible life and legacy, the IBTPP will press on towards our mission to provide and improve the treatment of infant botulism and to prevent infant botulism and related diseases.

• #36 Infant Botulism – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/infant-botulism

  Infant botulism results from ingestion of Clostridium botulinum spores, their colonization of the large intestine, and toxin production in vivo. […] Treatment is with support and human botulism immune globulin. […] Treatment of infant botulism is started as soon as the diagnosis is suspected; waiting for confirmatory test results, which may take days, is dangerous. […] Specific treatment of infant botulism is with human botulism immune globulin (BabyBIG), which is available from the Infant Botulism Treatment and Prevention Program (IBTPPcall 510-231-7600 or visit the IBTPP web site). […] The dose of human botulinum immune globulin is 50 mg/kg IV, given slowly. […] The horse serum heptavalent antitoxin used in adults is not recommended for infants. […] Antibiotics are not given because they may lyse C. botulinum in the gut and increase toxin availability.

• #37 Botulism – Wikipedia

  https://en.wikipedia.org/wiki/Botulism

  In adults, a trivalent antitoxin containing antibodies raised against botulinum toxin types A, B, and E is used most commonly; however, a heptavalent botulism antitoxin has also been developed and was approved by the U.S. FDA in 2013. […] In infants, horse-derived antitoxin is sometimes avoided for fear of infants developing serum sickness or lasting hypersensitivity to horse-derived proteins. To avoid this, a human-derived antitoxin has been developed and approved by the U.S. FDA in 2003 for the treatment of infant botulism. This human-derived antitoxin has been shown to be both safe and effective for the treatment of infant botulism.

• #38 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Approximately one-half of all patients with infant botulism, whether or not they are treated with BabyBIG, will require mechanical ventilatory support because of inability to protect their airway and/or respiratory insufficiency. […] Antibiotics are not efficacious in the treatment of infant botulism. Furthermore, there is concern that in non-BabyBIG-treated patients, administration of antibiotics with clostridiocidal activity may increase the amount of free toxin in the large bowel and actually worsen the patient’s clinical status. Antibiotic use in infant botulism patients is indicated only for the treatment of secondary infections. […] When considering extubation of an infant with infant botulism, every effort should be made to ensure adequate staffing, expertise and resources should the extubation attempt fail and the infant require reintubation.

• #39 Infant Botulism – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/infant-botulism

  Infant botulism results from ingestion of Clostridium botulinum spores, their colonization of the large intestine, and toxin production in vivo. […] Treatment is with support and human botulism immune globulin. […] Treatment of infant botulism is started as soon as the diagnosis is suspected; waiting for confirmatory test results, which may take days, is dangerous. […] Specific treatment of infant botulism is with human botulism immune globulin (BabyBIG), which is available from the Infant Botulism Treatment and Prevention Program (IBTPPcall 510-231-7600 or visit the IBTPP web site). […] The dose of human botulinum immune globulin is 50 mg/kg IV, given slowly. […] The horse serum heptavalent antitoxin used in adults is not recommended for infants. […] Antibiotics are not given because they may lyse C. botulinum in the gut and increase toxin availability.

• #40 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Adequate nutrition is of great importance. Although gut motility is slow in these patients, enteral feedings are generally well-tolerated and well-absorbed and should be instituted as soon as possible. […] Enteral feeding obviates the need for a long-term, in-dwelling intravenous line with its attendant risk of infection. Expressed breast milk given by NG or NJ feeding tubes constitutes optimal nutrition, and breastfeeding mothers should be encouraged and supported in this effort. […] Treatment with aminoglycoside antibiotics may potentiate the effect of botulinum neurotoxin at the neuromuscular junction, even in infants that have been treated with BabyBIG. Therefore, extra caution should be exercised when weaning ventilatory support from infants who have infant botulism and have received aminoglycoside antibiotics.

• #41 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Approximately one-half of all patients with infant botulism, whether or not they are treated with BabyBIG, will require mechanical ventilatory support because of inability to protect their airway and/or respiratory insufficiency. […] Antibiotics are not efficacious in the treatment of infant botulism. Furthermore, there is concern that in non-BabyBIG-treated patients, administration of antibiotics with clostridiocidal activity may increase the amount of free toxin in the large bowel and actually worsen the patient’s clinical status. Antibiotic use in infant botulism patients is indicated only for the treatment of secondary infections. […] When considering extubation of an infant with infant botulism, every effort should be made to ensure adequate staffing, expertise and resources should the extubation attempt fail and the infant require reintubation.

• #42 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Adequate nutrition is of great importance. Although gut motility is slow in these patients, enteral feedings are generally well-tolerated and well-absorbed and should be instituted as soon as possible. […] Enteral feeding obviates the need for a long-term, in-dwelling intravenous line with its attendant risk of infection. Expressed breast milk given by NG or NJ feeding tubes constitutes optimal nutrition, and breastfeeding mothers should be encouraged and supported in this effort. […] Treatment with aminoglycoside antibiotics may potentiate the effect of botulinum neurotoxin at the neuromuscular junction, even in infants that have been treated with BabyBIG. Therefore, extra caution should be exercised when weaning ventilatory support from infants who have infant botulism and have received aminoglycoside antibiotics.

• #43 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Adequate nutrition is of great importance. Although gut motility is slow in these patients, enteral feedings are generally well-tolerated and well-absorbed and should be instituted as soon as possible. […] Enteral feeding obviates the need for a long-term, in-dwelling intravenous line with its attendant risk of infection. Expressed breast milk given by NG or NJ feeding tubes constitutes optimal nutrition, and breastfeeding mothers should be encouraged and supported in this effort. […] Treatment with aminoglycoside antibiotics may potentiate the effect of botulinum neurotoxin at the neuromuscular junction, even in infants that have been treated with BabyBIG. Therefore, extra caution should be exercised when weaning ventilatory support from infants who have infant botulism and have received aminoglycoside antibiotics.

• #44 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Adequate nutrition is of great importance. Although gut motility is slow in these patients, enteral feedings are generally well-tolerated and well-absorbed and should be instituted as soon as possible. […] Enteral feeding obviates the need for a long-term, in-dwelling intravenous line with its attendant risk of infection. Expressed breast milk given by NG or NJ feeding tubes constitutes optimal nutrition, and breastfeeding mothers should be encouraged and supported in this effort. […] Treatment with aminoglycoside antibiotics may potentiate the effect of botulinum neurotoxin at the neuromuscular junction, even in infants that have been treated with BabyBIG. Therefore, extra caution should be exercised when weaning ventilatory support from infants who have infant botulism and have received aminoglycoside antibiotics.

• #45 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Adequate nutrition is of great importance. Although gut motility is slow in these patients, enteral feedings are generally well-tolerated and well-absorbed and should be instituted as soon as possible. […] Enteral feeding obviates the need for a long-term, in-dwelling intravenous line with its attendant risk of infection. Expressed breast milk given by NG or NJ feeding tubes constitutes optimal nutrition, and breastfeeding mothers should be encouraged and supported in this effort. […] Treatment with aminoglycoside antibiotics may potentiate the effect of botulinum neurotoxin at the neuromuscular junction, even in infants that have been treated with BabyBIG. Therefore, extra caution should be exercised when weaning ventilatory support from infants who have infant botulism and have received aminoglycoside antibiotics.

• #46 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Botulism is a rare but life-threatening neuroparalytic syndrome caused by the botulinum neurotoxin, most often produced by the bacterium Clostridium botulinum. […] Prompt administration of botulinum antitoxin and supportive care is essential, though recovery can take months to years. […] The administration of polyvalent antitoxin to BoNT mitigates the clinical course of botulism. However, no true antidote exists, and disease management relies on potentially weeks of mechanical ventilation and other resource-heavy therapies while the body’s neuromuscular signaling mechanisms recover. […] Treatment of botulism consists of antitoxin administration, hospital admission, close monitoring, respiratory support as required, and debridement with antibiotic coverage in the case of wound botulism.

• #47 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G) – (Equine) ideally should be administered within 24 hours of symptom onset as the antitoxin cannot reverse existing paralysis, only toxin circulating in the blood. […] The greatest benefit is seen among those who receive it within 2 days of illness onset. […] However, regardless of time after disease onset, patients should still receive antitoxin to protect unaffected synapses from persistent circulating toxin, which is known to persist for weeks in the blood. […] Pregnant patients with suspected botulism should be treated with BAT just as nonpregnant patients. […] Supportive care in botulism management involves extensive interventions to address paralysis and related complications, emphasizing the maintenance of vital functions and the prevention of deterioration. […] Proper airway management is paramount in botulism cases due to the elevated risk for respiratory failure. […] Close monitoring and prompt intervention are essential to ensure adequate oxygenation. […] Hospitalization generally is recommended for patients with symptoms or toxin exposure to allow continuous observation and timely interventions if needed.

• #48 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Antitoxin therapy available to healthcare professionals currently exists in 2 forms: heptavalent equine serum antitoxin, indicated for patients older than 1 year, and human-derived immunoglobulin, indicated for infants younger than 1 year. […] The administration of antitoxin will not reverse neurological paralysis, given that BoNT binds irreversibly, but it will help stop disease progression. […] For wound botulism, debridement and antibiotic therapy are indicated following antitoxin administration. […] Close monitoring should include frequent clinical evaluation of ventilation, perfusion, upper airway integrity, continuous pulse oximetry, spirometry, and arterial blood gas measurement. […] Aggressive supportive care in an intensive care unit setting is recommended.

• #49 Botulism – Diagnosis & Treatment : Emergency Care BC

  https://emergencycarebc.ca/clinical_resource/clinical-summary/botulism-diagnosis-treatment/

  Botulism is a rare, potentially fatal disease caused by the toxin produced by Clostridium botulinum spores – a bacteria found in soil and honey, and on fruits, vegetables, meats, and fish. […] The treatment approach for all patients with botulism includes: Administration of botulism antitoxin heptavalent (BAT) as soon as possible after diagnosing botulism. Botulinum antitoxin binds to circulating botulinum toxins A to G to prevent the condition from getting worse but cannot reverse paralysis, thus, early administration is critical. […] Human-derived botulism immune globulin (BabyBIG) is indicated in infant botulism caused by botulinum toxins A or B, rather than BAT. […] Antibiotics are not recommended for infant botulism or adults with suspected gastrointestinal botulism because they could increase the amount of toxin. […] All patients with clinical findings suggestive of botulism should be hospitalized and monitored closely for signs of respiratory failure.

• #50 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Antitoxin therapy available to healthcare professionals currently exists in 2 forms: heptavalent equine serum antitoxin, indicated for patients older than 1 year, and human-derived immunoglobulin, indicated for infants younger than 1 year. […] The administration of antitoxin will not reverse neurological paralysis, given that BoNT binds irreversibly, but it will help stop disease progression. […] For wound botulism, debridement and antibiotic therapy are indicated following antitoxin administration. […] Close monitoring should include frequent clinical evaluation of ventilation, perfusion, upper airway integrity, continuous pulse oximetry, spirometry, and arterial blood gas measurement. […] Aggressive supportive care in an intensive care unit setting is recommended.

• #51 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Antitoxin therapy available to healthcare professionals currently exists in 2 forms: heptavalent equine serum antitoxin, indicated for patients older than 1 year, and human-derived immunoglobulin, indicated for infants younger than 1 year. […] The administration of antitoxin will not reverse neurological paralysis, given that BoNT binds irreversibly, but it will help stop disease progression. […] For wound botulism, debridement and antibiotic therapy are indicated following antitoxin administration. […] Close monitoring should include frequent clinical evaluation of ventilation, perfusion, upper airway integrity, continuous pulse oximetry, spirometry, and arterial blood gas measurement. […] Aggressive supportive care in an intensive care unit setting is recommended.

• #52 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G) – (Equine) ideally should be administered within 24 hours of symptom onset as the antitoxin cannot reverse existing paralysis, only toxin circulating in the blood. […] The greatest benefit is seen among those who receive it within 2 days of illness onset. […] However, regardless of time after disease onset, patients should still receive antitoxin to protect unaffected synapses from persistent circulating toxin, which is known to persist for weeks in the blood. […] Pregnant patients with suspected botulism should be treated with BAT just as nonpregnant patients. […] Supportive care in botulism management involves extensive interventions to address paralysis and related complications, emphasizing the maintenance of vital functions and the prevention of deterioration. […] Proper airway management is paramount in botulism cases due to the elevated risk for respiratory failure. […] Close monitoring and prompt intervention are essential to ensure adequate oxygenation. […] Hospitalization generally is recommended for patients with symptoms or toxin exposure to allow continuous observation and timely interventions if needed.

• #53 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  Wound botulism requires incision and thorough debridement of the infected wound, antitoxin therapy, and antibiotics should be provided as clinically indicated. […] Consultations with an infectious diseases specialist and a neurologist frequently are beneficial. […] A nutritionist should be consulted for hyperalimentation and tube-feeding recommendations and monitoring. […] Physical and occupational therapists are needed to work on range-of-motion exercises and assisted ambulation, as tolerated. […] Nasogastric suction and intravenous hyperalimentation are important when an ileus is present. […] If no ileus is present or when the ileus resolves, tube feeding can be used for nutritional supplementation. […] Bedrest initially is required. […] Increase activity as tolerated.

• #54 Botulism in Dogs | VCA Animal Hospitals

  https://vcahospitals.com/know-your-pet/botulism-in-dogs

  If botulism exposure is known or suspected before the onset of clinical signs, the botulinum antitoxin can be administered. The antitoxin prevents the botulinum toxin from binding to nerve endings and causing clinical signs. Once signs of paralysis develop, the antitoxin is not effective. […] Once signs have developed, treatment of botulism is focused on supportive care. The signs of botulism will typically resolve with time, and supportive care decreases the likelihood of complications. Affected dogs should be kept hospitalized on soft bedding, to prevent pressure sores. Mildly affected dogs may need assistance with eating or drinking, while more severely affected dogs may require intravenous fluids to prevent dehydration and a stomach tube for feeding. […] Antibiotics may be given to treat secondary infections that may occur. If your dog’s diaphragm becomes paralyzed, a mechanical ventilator may be used to allow him to breathe.

• #55 Botulism in Horses | PetMD

  https://www.petmd.com/horse/conditions/digestive/botulism-in-horses

  Without quick, aggressive treatment and intensive supportive care, botulism is often fatal in horses. […] An intravenous antitoxin is available, with the goal of neutralizing the circulating toxin. […] Unfortunately, antitoxin therapy will not reverse existing clinical signs and may not stop the disease from progressing. […] Supportive care at a veterinary hospital is often required and may include the following: Frequent turning of horses who are lying down (to avoid pressure sores), Feeding through a nasogastric tube, Daily eye lubrication, Sedation to reduce muscle activity, Stall rest, Antimicrobial therapy (for secondary complications such as aspiration pneumonia). […] Recovery from botulism is dependent on the following factors: Dose of toxin (how much toxin is in the horse’s body), Severity of clinical signs, Time of diagnosis, Quick and aggressive treatment.

• #56 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  Wound botulism requires incision and thorough debridement of the infected wound, antitoxin therapy, and antibiotics should be provided as clinically indicated. […] Consultations with an infectious diseases specialist and a neurologist frequently are beneficial. […] A nutritionist should be consulted for hyperalimentation and tube-feeding recommendations and monitoring. […] Physical and occupational therapists are needed to work on range-of-motion exercises and assisted ambulation, as tolerated. […] Nasogastric suction and intravenous hyperalimentation are important when an ileus is present. […] If no ileus is present or when the ileus resolves, tube feeding can be used for nutritional supplementation. […] Bedrest initially is required. […] Increase activity as tolerated.

• #57 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  Wound botulism requires incision and thorough debridement of the infected wound, antitoxin therapy, and antibiotics should be provided as clinically indicated. […] Consultations with an infectious diseases specialist and a neurologist frequently are beneficial. […] A nutritionist should be consulted for hyperalimentation and tube-feeding recommendations and monitoring. […] Physical and occupational therapists are needed to work on range-of-motion exercises and assisted ambulation, as tolerated. […] Nasogastric suction and intravenous hyperalimentation are important when an ileus is present. […] If no ileus is present or when the ileus resolves, tube feeding can be used for nutritional supplementation. […] Bedrest initially is required. […] Increase activity as tolerated.

• #58 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  Wound botulism requires incision and thorough debridement of the infected wound, antitoxin therapy, and antibiotics should be provided as clinically indicated. […] Consultations with an infectious diseases specialist and a neurologist frequently are beneficial. […] A nutritionist should be consulted for hyperalimentation and tube-feeding recommendations and monitoring. […] Physical and occupational therapists are needed to work on range-of-motion exercises and assisted ambulation, as tolerated. […] Nasogastric suction and intravenous hyperalimentation are important when an ileus is present. […] If no ileus is present or when the ileus resolves, tube feeding can be used for nutritional supplementation. […] Bedrest initially is required. […] Increase activity as tolerated.

• #59 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  It is essential to administer botulinum antitoxin promptly based on clinical findings without waiting for laboratory confirmation, as administering the treatment within the first 2 days of symptom onset offers the most significant benefit. […] Healthcare providers also should consider the possibility of botulism in pregnant patients and treat them with the same urgency and protocols as nonpregnant patients. […] Additionally, it is crucial to provide comprehensive support that addresses both the physical and psychological impacts of the illness on patients and their families. […] Finally, proactive planning for potential antitoxin shortages is necessary, ensuring that effective systems are in place to manage such crises efficiently. […] On March 22, 2013, the FDA approved the first botulism antitoxin that can neutralize all 7 known botulinum nerve toxin serotypes. […] The heptavalent antitoxin is derived from horse plasma and is the only drug available for treating botulism in patients older than 1 year, including adults. […] It also is the only available drug for treating infant botulism that is not caused by nerve toxin type A or B; otherwise, human-origin anti-A, anti-B botulinum antitoxin (BabyBIG) should be obtained from the California Infant Botulism Treatment and Prevention Program at +1 510-231-7600 (do not use equine antitoxin for infants).

• #60 Botulism – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266

  For cases of foodborne botulism, health care providers sometimes clear out the digestive system by causing vomiting and giving drugs to help you move your bowels. If you have wound botulism, a provider may need to remove infected tissue in a surgery. […] If you’re diagnosed early with foodborne or wound botulism, injected antitoxin lowers the risk of complications. The antitoxin attaches itself to toxin that’s moving through your bloodstream and keeps it from harming your nerves. […] The antitoxin can’t reverse damage that’s already been done. But nerves can repair themselves. Many people recover fully. But recovery may take months and typically involves extended rehabilitation therapy. […] Antibiotics are recommended for the treatment of wound botulism. These drugs aren’t used for other forms of botulism because they can speed up the release of toxins.

• #61 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  If you have wound botulism, you may need an operation to remove the contaminated part of your wound surgically. After the operation, you may take antibiotics to keep the infection from coming back. […] No specific treatment will cure botulism, though mild nerve damage can heal. Antitoxins can stop further damage from the toxin. […] Botulism can paralyze the muscles that help you swallow and breathe. While antitoxins can help in many cases, some people do die of breathing problems and infections. […] Depending on the severity of your case, recovery from botulism can take weeks, months or even years. Most people who receive prompt treatment recover completely in fewer than two weeks.

• #62 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  If you have wound botulism, you may need an operation to remove the contaminated part of your wound surgically. After the operation, you may take antibiotics to keep the infection from coming back. […] No specific treatment will cure botulism, though mild nerve damage can heal. Antitoxins can stop further damage from the toxin. […] Botulism can paralyze the muscles that help you swallow and breathe. While antitoxins can help in many cases, some people do die of breathing problems and infections. […] Depending on the severity of your case, recovery from botulism can take weeks, months or even years. Most people who receive prompt treatment recover completely in fewer than two weeks.

• #63 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/pages/botulism.aspx

  Botulism is a rare but serious disease caused by a toxin (poison) that attacks the nervous system and causes paralysis. Anyone can get botulism. […] If you or someone you know has symptoms of botulism, call 911 or go to the emergency room immediately. […] Botulism is a very serious disease that can be deadly if not treated. If caught early, botulism can be treated with botulinum antitoxin, which blocks the toxin from causing more harm in the body. But the antitoxin can’t undo any muscle paralysis that has already happened, so it can take weeks or even months for a person to get better. A person with severe botulism may need help breathing and may need to be on a breathing machine (ventilator) for weeks with intensive medical care. […] Botulinum antitoxin for patients 15 months of age and older in California is available by working with the local public health department, CDPH, and the U.S. Centers for Disease Control and Prevention (CDC). If the diagnosis of botulism is suspected, healthcare providers can ask for the botulinum antitoxin through their local health department, which will work with CDPH and CDC to release the antitoxin. For infant botulism, healthcare providers should contact the CDPH Infant Botulism Treatment and Prevention Program to obtain the licensed human botulinum antitoxin, BabyBIG.

• #64 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  If you have wound botulism, you may need an operation to remove the contaminated part of your wound surgically. After the operation, you may take antibiotics to keep the infection from coming back. […] No specific treatment will cure botulism, though mild nerve damage can heal. Antitoxins can stop further damage from the toxin. […] Botulism can paralyze the muscles that help you swallow and breathe. While antitoxins can help in many cases, some people do die of breathing problems and infections. […] Depending on the severity of your case, recovery from botulism can take weeks, months or even years. Most people who receive prompt treatment recover completely in fewer than two weeks.

• #65 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Just as infant botulism has a characteristic presentation, so too the course of the disease has some generally predictable features. Hospitalized patients usually have acute to subacute onset of symptoms over several days, with progression of weakness (usually manifesting as feeding or breathing difficulties) that finally necessitates hospital admission. In patients not treated with BabyBIG whose weakness continues to advance, the low point is generally reached within 1-2 weeks after admission. Patients may remain at this stage for as long as 2-3 weeks before showing improvement. Once improvement begins, it continues, albeit slowly, over the subsequent weeks. Average hospital stay for non-BabyBIG-treated patients is approximately 5.7 weeks. In contrast, patients treated with BabyBIG have an average hospital stay of approximately 2.3 weeks, and their recovery of strength, tone and movement occurs more rapidly.

• #66 Botulism – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266

  If you’re having trouble breathing, you probably need a mechanical ventilator for up to several weeks while your body fights the toxin’s effects. The ventilator forces air into your lungs through a tube inserted in your airway through your nose or mouth. […] As you recover, you may also need therapy to improve your speech, swallowing and other functions affected by botulism.

• #67 Botulism: Types, Symptoms, Diagnosis, Treatment

  https://www.webmd.com/food-recipes/food-poisoning/what-is-botulism

  Your doctor will have you admitted to a hospital, where several treatments may be tried, depending on your case. They include: […] The main treatment for botulism is a medication called an antitoxin. It interferes with the toxin in your bloodstream. This medication can often help stop symptoms from getting worse. […] Sometimes these may work if your case is wound botulism. These bacteria-killing medications arent used for other types of botulism. […] If your case of botulism has seriously affected your muscles for breathing, you may need to be hooked up to a machine that helps you breathe. You may be on a mechanical ventilation machine for months if the illness is severe. […] You may need programs to help with your speech, swallowing, and other body functions as you start to get better.

• #68 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Botulism-Treatment-and-Prevention.aspx

  The standard of care for treating botulism is administration of antitoxin. It binds directly with the bacterial toxin and prevents it from causing more damage to the nervous system. However, the drug cannot heal the damage already done by the toxins. The mortality rates can be significantly reduced with an immediate antitoxin treatment. In infants, botulism is treated with an antitoxin called botulism immune globulin. […] In wound botulism, surgery may be necessary to remove the affected tissue. Antibiotics may be indicated to limit growth of botulism and other co-infecting bacteria in wounds. However, antibiotics are not recommended for other botulism types because these medicines can increase the rate of toxin release. […] If the botulism is associated with breathing difficulties, a mechanical ventilator may be used to help the patient breath normally until the severity of symptoms reduces gradually. After completion of the treatment, people who present with fatigue, speech problems, shortness of breath, and swallowing difficulties may need long-term rehabilitation for months or years to recover.

• #69 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Regardless of whether or not the patient has received anti-toxin, the infant should have good to full recovery of muscle strength and tone before immunizations resume. This delay is advised to avoid any confusion surrounding what might be a vaccine-related reaction versus clinical worsening of the infant botulism disease process.

• #70 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/physician/patient.php

  Regardless of whether or not the patient has received anti-toxin, the infant should have good to full recovery of muscle strength and tone before immunizations resume. This delay is advised to avoid any confusion surrounding what might be a vaccine-related reaction versus clinical worsening of the infant botulism disease process.

• #71 Botulism treatment reverses paralysis in mice – Boston Children’s Answers

  https://answers.childrenshospital.org/botulism-treatment-delivery-platform/

  A new botulism treatment may reverse paralysis after it occurs. […] Once paralysis develops, there is no way to reverse it, other than waiting for the toxins to wear off. […] But a new botulism treatment and delivery vehicle, described today in Science Translational Medicine, could change that. […] What we have developed is the first therapy that can eliminate toxins after they get inside neurons. […] If proven in humans, the approach would represent a breakthrough in treating botulism. […] The treatment harnesses a botulinum toxin (detoxified through introduced mutations) as the delivery vehicle. […] We can potentially inject our therapeutic protein and get rid of botox in neurons and paralysis within a few hours. […] We provide a protein-based drug delivery platform that achieves highly specific targeting of neurons and efficient penetration of cell membranes.

• #72

  https://insight.jci.org/articles/view/132891

  Based on the molecular and cellular toxicokinetics of intoxication, a comprehensive therapeutic paradigm for botulism would include (a) broad-spectrum antitoxins to terminate exposure, (b) intracellular antidotes to block LC proteolysis of SNARE proteins, and (c) symptomatic treatments that enhance neuromuscular function and mitigate muscle weakness, with mechanical ventilation administered as needed to ensure survival. […] Thus, there remains a critical need for complementary therapies that promote respiratory function and reduce or eliminate the need for ventilation. […] 3,4-DAP is a selective potassium channel blocker that prolongs neuronal action potential duration, thereby increasing Ca2+ influx through presynaptic voltage-gated Ca2+ channels. […] Collectively, these findings suggest that 3,4-DAP could be effective as a symptomatic treatment for clinical botulism at multiple time points, independent of serotype, and with enhanced potency in cases of type A botulism.

• #73

  https://insight.jci.org/articles/view/132891

  Botulinum neurotoxins (BoNTs) are potent neuroparalytic toxins that cause mortality through respiratory paralysis. The approved medical countermeasure for BoNT poisoning is infusion of antitoxin immunoglobulins. However, antitoxins have poor therapeutic efficacy in symptomatic patients; thus, there is an urgent need for treatments that reduce the need for artificial ventilation. […] We report that the US Food and Drug Administration approved potassium channel blocker 3,4-diaminopyridine (3,4-DAP) reverses respiratory depression and neuromuscular weakness in murine models of acute and chronic botulism. […] These findings make a compelling argument for repurposing 3,4-DAP to symptomatically treat symptoms of muscle paralysis caused by botulism, independent of serotype. Furthermore, they suggest that 3,4-DAP is effective for a range of botulism symptoms at clinically relevant time points.

• #74

  https://insight.jci.org/articles/view/132891

  Here, we test the hypothesis that 3,4-DAP improves respiratory and skeletal muscle paralysis in vivo at clinically relevant time points after exposure to BoNT serotypes A, B, and E. […] 3,4-DAP treatment significantly improved survival and prolonged TD50 compared with vehicle-treated mice. […] 3,4-DAP is a potentially important adjunct to the FDA-approved heptavalent botulism antitoxin (HBAT). […] Our findings suggest that 3,4-DAP would be particularly effective in mitigating chronic muscle weakness resulting from delayed HBAT administration, thus accelerating overall recovery. […] Collectively, these data make a compelling preclinical case for use of 3,4-DAP to treat a range of botulism symptoms.

• #75 New Research Shows Drug Used to Treat Neuromuscular Weakness Could Counter Botulism | Wake Forest University School of Medicine

  https://school.wakehealth.edu/research/institutes-and-centers/wake-forest-institute-for-regenerative-medicine/awards-honors-and-media-coverage/2022/new-research-shows-drug-used-to-treat-neuromuscular-weakness-could-counter-botulism

  Botulinum neurotoxins (BoNTs) are a family of bacterial poisons the most poisonous substances known responsible for the clinical disease known as botulism. […] Currently, the only specific treatment for botulism is early administration with antitoxin. […] Despite decades of effort, there are no antidotes for the life-threatening consequences of botulism. […] The researchers build on their previous work to show that administration of the FDA-approved drug 3,4-diaminopyridine (3,4-DAP) reverses botulism symptoms in a pre-clinical model. […] This is the first small-molecule therapy to directly reverse toxic signs and promote survival when administered post-symptomatically after a lethal dose of botulism, said McNutt. Our data supports the immediate clinical use of DAP in botulism patients.

• #76 Botulism treatment reverses paralysis in mice – Boston Children’s Answers

  https://answers.childrenshospital.org/botulism-treatment-delivery-platform/

  A new botulism treatment may reverse paralysis after it occurs. […] Once paralysis develops, there is no way to reverse it, other than waiting for the toxins to wear off. […] But a new botulism treatment and delivery vehicle, described today in Science Translational Medicine, could change that. […] What we have developed is the first therapy that can eliminate toxins after they get inside neurons. […] If proven in humans, the approach would represent a breakthrough in treating botulism. […] The treatment harnesses a botulinum toxin (detoxified through introduced mutations) as the delivery vehicle. […] We can potentially inject our therapeutic protein and get rid of botox in neurons and paralysis within a few hours. […] We provide a protein-based drug delivery platform that achieves highly specific targeting of neurons and efficient penetration of cell membranes.

• #77 Botulism treatment reverses paralysis in mice – Boston Children’s Answers

  https://answers.childrenshospital.org/botulism-treatment-delivery-platform/

  A new botulism treatment may reverse paralysis after it occurs. […] Once paralysis develops, there is no way to reverse it, other than waiting for the toxins to wear off. […] But a new botulism treatment and delivery vehicle, described today in Science Translational Medicine, could change that. […] What we have developed is the first therapy that can eliminate toxins after they get inside neurons. […] If proven in humans, the approach would represent a breakthrough in treating botulism. […] The treatment harnesses a botulinum toxin (detoxified through introduced mutations) as the delivery vehicle. […] We can potentially inject our therapeutic protein and get rid of botox in neurons and paralysis within a few hours. […] We provide a protein-based drug delivery platform that achieves highly specific targeting of neurons and efficient penetration of cell membranes.

• #78 Botulism treatment reverses paralysis in mice – Boston Children’s Answers

  https://answers.childrenshospital.org/botulism-treatment-delivery-platform/

  A new botulism treatment may reverse paralysis after it occurs. […] Once paralysis develops, there is no way to reverse it, other than waiting for the toxins to wear off. […] But a new botulism treatment and delivery vehicle, described today in Science Translational Medicine, could change that. […] What we have developed is the first therapy that can eliminate toxins after they get inside neurons. […] If proven in humans, the approach would represent a breakthrough in treating botulism. […] The treatment harnesses a botulinum toxin (detoxified through introduced mutations) as the delivery vehicle. […] We can potentially inject our therapeutic protein and get rid of botox in neurons and paralysis within a few hours. […] We provide a protein-based drug delivery platform that achieves highly specific targeting of neurons and efficient penetration of cell membranes.

• #79 Botulism treatment reverses paralysis in mice – Boston Children’s Answers

  https://answers.childrenshospital.org/botulism-treatment-delivery-platform/

  A new botulism treatment may reverse paralysis after it occurs. […] Once paralysis develops, there is no way to reverse it, other than waiting for the toxins to wear off. […] But a new botulism treatment and delivery vehicle, described today in Science Translational Medicine, could change that. […] What we have developed is the first therapy that can eliminate toxins after they get inside neurons. […] If proven in humans, the approach would represent a breakthrough in treating botulism. […] The treatment harnesses a botulinum toxin (detoxified through introduced mutations) as the delivery vehicle. […] We can potentially inject our therapeutic protein and get rid of botox in neurons and paralysis within a few hours. […] We provide a protein-based drug delivery platform that achieves highly specific targeting of neurons and efficient penetration of cell membranes.

• #80 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8112830/

  Botulism is a rare, neurotoxin-mediated, life-threatening disease characterized by flaccid descending paralysis that begins with cranial nerve palsies and might progress to extremity weakness and respiratory failure. […] Treatment involves supportive care, intubation and mechanical ventilation when necessary, and administration of botulinum antitoxin. […] In the United States, botulinum antitoxin (to treat suspected botulism, other than infant botulism) is available emergently and free of charge from the federal government. […] The recommendations in these guidelines address the conventional standard of care, in which medical resources are not limited, as well as settings of contingency and crisis standards of care, with limited medical resources. […] The only specific therapy for botulism is botulinum antitoxin.

• #81 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8112830/

  Botulism is a rare, neurotoxin-mediated, life-threatening disease characterized by flaccid descending paralysis that begins with cranial nerve palsies and might progress to extremity weakness and respiratory failure. […] Treatment involves supportive care, intubation and mechanical ventilation when necessary, and administration of botulinum antitoxin. […] In the United States, botulinum antitoxin (to treat suspected botulism, other than infant botulism) is available emergently and free of charge from the federal government. […] The recommendations in these guidelines address the conventional standard of care, in which medical resources are not limited, as well as settings of contingency and crisis standards of care, with limited medical resources. […] The only specific therapy for botulism is botulinum antitoxin.

• #82 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8112830/

  When administered early in the course of illness (within 48 hours of symptom onset and ideally within 24 hours), botulinum antitoxin can stop the progression of paralysis and prevent respiratory compromise in certain patients. […] Health care providers who suspect botulism on the basis of clinical symptoms should immediately call the emergency contact number of their local or state health department to arrange for an emergency clinical consultation and, when indicated, shipment of antitoxin. […] Administer botulinum antitoxin to patients with suspected botulism as early as possible in the course of illness. […] Patients with suspected botulism whose symptoms or signs (e.g., paralysis) are progressing should be treated with BAT regardless of the time that has elapsed since symptom onset. […] Patients with suspected botulism should be treated with BAT regardless of underlying medical conditions or age, sex, or other demographic characteristics.

• #83 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/pages/botulism.aspx

  Botulism is a rare but serious disease caused by a toxin (poison) that attacks the nervous system and causes paralysis. Anyone can get botulism. […] If you or someone you know has symptoms of botulism, call 911 or go to the emergency room immediately. […] Botulism is a very serious disease that can be deadly if not treated. If caught early, botulism can be treated with botulinum antitoxin, which blocks the toxin from causing more harm in the body. But the antitoxin can’t undo any muscle paralysis that has already happened, so it can take weeks or even months for a person to get better. A person with severe botulism may need help breathing and may need to be on a breathing machine (ventilator) for weeks with intensive medical care. […] Botulinum antitoxin for patients 15 months of age and older in California is available by working with the local public health department, CDPH, and the U.S. Centers for Disease Control and Prevention (CDC). If the diagnosis of botulism is suspected, healthcare providers can ask for the botulinum antitoxin through their local health department, which will work with CDPH and CDC to release the antitoxin. For infant botulism, healthcare providers should contact the CDPH Infant Botulism Treatment and Prevention Program to obtain the licensed human botulinum antitoxin, BabyBIG.

• #84 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  It is essential to administer botulinum antitoxin promptly based on clinical findings without waiting for laboratory confirmation, as administering the treatment within the first 2 days of symptom onset offers the most significant benefit. […] Healthcare providers also should consider the possibility of botulism in pregnant patients and treat them with the same urgency and protocols as nonpregnant patients. […] Additionally, it is crucial to provide comprehensive support that addresses both the physical and psychological impacts of the illness on patients and their families. […] Finally, proactive planning for potential antitoxin shortages is necessary, ensuring that effective systems are in place to manage such crises efficiently. […] On March 22, 2013, the FDA approved the first botulism antitoxin that can neutralize all 7 known botulinum nerve toxin serotypes. […] The heptavalent antitoxin is derived from horse plasma and is the only drug available for treating botulism in patients older than 1 year, including adults. […] It also is the only available drug for treating infant botulism that is not caused by nerve toxin type A or B; otherwise, human-origin anti-A, anti-B botulinum antitoxin (BabyBIG) should be obtained from the California Infant Botulism Treatment and Prevention Program at +1 510-231-7600 (do not use equine antitoxin for infants).

• #85

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/botulism.aspx

  BAT is licensed by the US Food and Drug Administration (USFDA) For the treatment of symptomatic botulism following documented or suspected exposure to botulinum neurotoxin serotypes A, B, C, D, E, F, or G in adults and paediatric patients. […] Human-derived botulism immune globulin for intravenous use (BabyBIG) is licensed by the USFDA for the treatment of infant botulism caused by C. botulinum with serotype A or type B toxins. […] Antibiotics are not indicated in infant botulism. Aminoglycoside agents potentiate the paralytic effects of the toxin and should be avoided. Penicillin or metronidazole should be given to patients with wound botulism after antitoxin has been administered. […] The case or relevant care-giver should be informed about the nature of the infection and the mode of transmission. Emphasise the importance of correct food handling procedures, particularly food preservation.

• #86 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  It is essential to administer botulinum antitoxin promptly based on clinical findings without waiting for laboratory confirmation, as administering the treatment within the first 2 days of symptom onset offers the most significant benefit. […] Healthcare providers also should consider the possibility of botulism in pregnant patients and treat them with the same urgency and protocols as nonpregnant patients. […] Additionally, it is crucial to provide comprehensive support that addresses both the physical and psychological impacts of the illness on patients and their families. […] Finally, proactive planning for potential antitoxin shortages is necessary, ensuring that effective systems are in place to manage such crises efficiently. […] On March 22, 2013, the FDA approved the first botulism antitoxin that can neutralize all 7 known botulinum nerve toxin serotypes. […] The heptavalent antitoxin is derived from horse plasma and is the only drug available for treating botulism in patients older than 1 year, including adults. […] It also is the only available drug for treating infant botulism that is not caused by nerve toxin type A or B; otherwise, human-origin anti-A, anti-B botulinum antitoxin (BabyBIG) should be obtained from the California Infant Botulism Treatment and Prevention Program at +1 510-231-7600 (do not use equine antitoxin for infants).

• #87 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/

  Infant botulism is a novel form of human botulism in which ingested spores of the bacterium Clostridium botulinum colonize and grow in the infant’s large intestine and produce botulinum neurotoxin in it. […] However, in the absence of complications, patients recover completely from the disease. […] After fellowship, Steve founded what would become the Infant Botulism Treatment and Prevention Program (IBTPP), a unit of the California Department of Public Health (CDPH). […] His relentless efforts to alert the public to avoid feeding honey to infants were joined internationally by pediatric and public health authorities, eventually resulting in voluntary labelling of commercial honey in the US. […] It has been distributed to all 50 United States and worldwide to treat over 3,000 infants to date.

• #88

  https://www.health.nsw.gov.au/Infectious/controlguideline/Pages/botulism.aspx

  BAT is licensed by the US Food and Drug Administration (USFDA) For the treatment of symptomatic botulism following documented or suspected exposure to botulinum neurotoxin serotypes A, B, C, D, E, F, or G in adults and paediatric patients. […] Human-derived botulism immune globulin for intravenous use (BabyBIG) is licensed by the USFDA for the treatment of infant botulism caused by C. botulinum with serotype A or type B toxins. […] Antibiotics are not indicated in infant botulism. Aminoglycoside agents potentiate the paralytic effects of the toxin and should be avoided. Penicillin or metronidazole should be given to patients with wound botulism after antitoxin has been administered. […] The case or relevant care-giver should be informed about the nature of the infection and the mode of transmission. Emphasise the importance of correct food handling procedures, particularly food preservation.

• #89 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/

  Infant botulism is a novel form of human botulism in which ingested spores of the bacterium Clostridium botulinum colonize and grow in the infant’s large intestine and produce botulinum neurotoxin in it. […] However, in the absence of complications, patients recover completely from the disease. […] After fellowship, Steve founded what would become the Infant Botulism Treatment and Prevention Program (IBTPP), a unit of the California Department of Public Health (CDPH). […] His relentless efforts to alert the public to avoid feeding honey to infants were joined internationally by pediatric and public health authorities, eventually resulting in voluntary labelling of commercial honey in the US. […] It has been distributed to all 50 United States and worldwide to treat over 3,000 infants to date.

• #90 Welcome to the Infant Botulism Treatment and Prevention Program

  https://www.infantbotulism.org/

  Infant botulism is a novel form of human botulism in which ingested spores of the bacterium Clostridium botulinum colonize and grow in the infant’s large intestine and produce botulinum neurotoxin in it. […] However, in the absence of complications, patients recover completely from the disease. […] After fellowship, Steve founded what would become the Infant Botulism Treatment and Prevention Program (IBTPP), a unit of the California Department of Public Health (CDPH). […] His relentless efforts to alert the public to avoid feeding honey to infants were joined internationally by pediatric and public health authorities, eventually resulting in voluntary labelling of commercial honey in the US. […] It has been distributed to all 50 United States and worldwide to treat over 3,000 infants to date.

• #91 Botulism – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/symptoms-causes/syc-20370262

  Seek urgent medical care if you suspect that you have botulism. Initial treatment increases your survival chances and lowers your risk of complications. […] Rarely, botulism happens when too much botulinum toxin is injected for cosmetic reasons, such as removing wrinkles, or for medical reasons, such as treating migraines. […] To prevent iatrogenic botulism, be sure to go to a licensed health care provider for any cosmetic or medical procedures using various forms of botulinum toxin. They include onabotulinumtoxinA (Botox), abobotulinumtoxinA (Dysport) and others.

• #92 Botulism – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/symptoms-causes/syc-20370262

  Seek urgent medical care if you suspect that you have botulism. Initial treatment increases your survival chances and lowers your risk of complications. […] Rarely, botulism happens when too much botulinum toxin is injected for cosmetic reasons, such as removing wrinkles, or for medical reasons, such as treating migraines. […] To prevent iatrogenic botulism, be sure to go to a licensed health care provider for any cosmetic or medical procedures using various forms of botulinum toxin. They include onabotulinumtoxinA (Botox), abobotulinumtoxinA (Dysport) and others.

• #93 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021 | MMWR

  https://www.cdc.gov/mmwr/volumes/70/rr/rr7002a1.htm

  Botulism is a rare, neurotoxin-mediated, life-threatening disease characterized by flaccid descending paralysis that begins with cranial nerve palsies and might progress to extremity weakness and respiratory failure. […] Treatment involves supportive care, intubation and mechanical ventilation when necessary, and administration of botulinum antitoxin. […] Before the publication of these guidelines, no comprehensive clinical care guidelines existed for treating botulism. […] The recommendations in these guidelines address the conventional standard of care, in which medical resources are not limited, as well as settings of contingency and crisis standards of care, with limited medical resources. […] The only specific therapy for botulism is botulinum antitoxin. […] When administered early in the course of illness (within 48 hours of symptom onset and ideally within 24 hours), botulinum antitoxin can stop the progression of paralysis and prevent respiratory compromise in certain patients.

• #94 Botulism

  https://www.nhs.uk/conditions/botulism/

  Botulism needs to be treated in hospital. […] The way it’s treated depends on the type of botulism, but usually involves: neutralising the toxins with injections of special antitoxins or antibodies, supporting the functions of the body, such as breathing, until you recover. […] Treatment will not immediately reverse any paralysis that’s already been caused by the toxin, but will stop it getting any worse. […] In most people, paralysis that occurred before treatment will gradually improve over the following weeks or months.

• #95 Clinical Guidelines for Diagnosis and Treatment of Botulism, 2021

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8112830/

  When administered early in the course of illness (within 48 hours of symptom onset and ideally within 24 hours), botulinum antitoxin can stop the progression of paralysis and prevent respiratory compromise in certain patients. […] Health care providers who suspect botulism on the basis of clinical symptoms should immediately call the emergency contact number of their local or state health department to arrange for an emergency clinical consultation and, when indicated, shipment of antitoxin. […] Administer botulinum antitoxin to patients with suspected botulism as early as possible in the course of illness. […] Patients with suspected botulism whose symptoms or signs (e.g., paralysis) are progressing should be treated with BAT regardless of the time that has elapsed since symptom onset. […] Patients with suspected botulism should be treated with BAT regardless of underlying medical conditions or age, sex, or other demographic characteristics.

• #96 Botulism – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459273/

  Antitoxin therapy available to healthcare professionals currently exists in 2 forms: heptavalent equine serum antitoxin, indicated for patients older than 1 year, and human-derived immunoglobulin, indicated for infants younger than 1 year. […] The administration of antitoxin will not reverse neurological paralysis, given that BoNT binds irreversibly, but it will help stop disease progression. […] For wound botulism, debridement and antibiotic therapy are indicated following antitoxin administration. […] Close monitoring should include frequent clinical evaluation of ventilation, perfusion, upper airway integrity, continuous pulse oximetry, spirometry, and arterial blood gas measurement. […] Aggressive supportive care in an intensive care unit setting is recommended.

• #97 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  Wound botulism requires incision and thorough debridement of the infected wound, antitoxin therapy, and antibiotics should be provided as clinically indicated. […] Consultations with an infectious diseases specialist and a neurologist frequently are beneficial. […] A nutritionist should be consulted for hyperalimentation and tube-feeding recommendations and monitoring. […] Physical and occupational therapists are needed to work on range-of-motion exercises and assisted ambulation, as tolerated. […] Nasogastric suction and intravenous hyperalimentation are important when an ileus is present. […] If no ileus is present or when the ileus resolves, tube feeding can be used for nutritional supplementation. […] Bedrest initially is required. […] Increase activity as tolerated.

• #98 Botulism Treatment & Management: Approach Considerations, Medical Care, Surgical Care

  https://emedicine.medscape.com/article/213311-treatment

  Botulism Antitoxin Heptavalent (A, B, C, D, E, F, G) – (Equine) ideally should be administered within 24 hours of symptom onset as the antitoxin cannot reverse existing paralysis, only toxin circulating in the blood. […] The greatest benefit is seen among those who receive it within 2 days of illness onset. […] However, regardless of time after disease onset, patients should still receive antitoxin to protect unaffected synapses from persistent circulating toxin, which is known to persist for weeks in the blood. […] Pregnant patients with suspected botulism should be treated with BAT just as nonpregnant patients. […] Supportive care in botulism management involves extensive interventions to address paralysis and related complications, emphasizing the maintenance of vital functions and the prevention of deterioration. […] Proper airway management is paramount in botulism cases due to the elevated risk for respiratory failure. […] Close monitoring and prompt intervention are essential to ensure adequate oxygenation. […] Hospitalization generally is recommended for patients with symptoms or toxin exposure to allow continuous observation and timely interventions if needed.

• #99 Botulism – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/botulism/diagnosis-treatment/drc-20370266

  If you’re having trouble breathing, you probably need a mechanical ventilator for up to several weeks while your body fights the toxin’s effects. The ventilator forces air into your lungs through a tube inserted in your airway through your nose or mouth. […] As you recover, you may also need therapy to improve your speech, swallowing and other functions affected by botulism.

• #100 Botulism Outcomes and Long-Term and Permanent Injury | Marler Clark

  https://marlerclark.com/foodborne-illnesses/botulism/botulism-outcomes-and-long-term-and-permanent-injury

  In the past 50 years, mortality from botulism has fallen dramatically (from about 50% to 8%) because of advances in supportive care, which is the mainstay of treatment. […] Recovery from botulism takes many weeks. […] The cost of treating foodborne botulism can be considerable due to the complexity and length of the required medical care. Treatment expenses can vary widely based on the severity of …

• #101 Botulism: Types, Causes, Symptoms & Treatments

  https://my.clevelandclinic.org/health/diseases/17828-botulism

  If you have wound botulism, you may need an operation to remove the contaminated part of your wound surgically. After the operation, you may take antibiotics to keep the infection from coming back. […] No specific treatment will cure botulism, though mild nerve damage can heal. Antitoxins can stop further damage from the toxin. […] Botulism can paralyze the muscles that help you swallow and breathe. While antitoxins can help in many cases, some people do die of breathing problems and infections. […] Depending on the severity of your case, recovery from botulism can take weeks, months or even years. Most people who receive prompt treatment recover completely in fewer than two weeks.

• #102 Botulism treatment reverses paralysis in mice – Boston Children’s Answers

  https://answers.childrenshospital.org/botulism-treatment-delivery-platform/

  A new botulism treatment may reverse paralysis after it occurs. […] Once paralysis develops, there is no way to reverse it, other than waiting for the toxins to wear off. […] But a new botulism treatment and delivery vehicle, described today in Science Translational Medicine, could change that. […] What we have developed is the first therapy that can eliminate toxins after they get inside neurons. […] If proven in humans, the approach would represent a breakthrough in treating botulism. […] The treatment harnesses a botulinum toxin (detoxified through introduced mutations) as the delivery vehicle. […] We can potentially inject our therapeutic protein and get rid of botox in neurons and paralysis within a few hours. […] We provide a protein-based drug delivery platform that achieves highly specific targeting of neurons and efficient penetration of cell membranes.

• #103

  https://insight.jci.org/articles/view/132891

  Here, we test the hypothesis that 3,4-DAP improves respiratory and skeletal muscle paralysis in vivo at clinically relevant time points after exposure to BoNT serotypes A, B, and E. […] 3,4-DAP treatment significantly improved survival and prolonged TD50 compared with vehicle-treated mice. […] 3,4-DAP is a potentially important adjunct to the FDA-approved heptavalent botulism antitoxin (HBAT). […] Our findings suggest that 3,4-DAP would be particularly effective in mitigating chronic muscle weakness resulting from delayed HBAT administration, thus accelerating overall recovery. […] Collectively, these data make a compelling preclinical case for use of 3,4-DAP to treat a range of botulism symptoms.

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