Botulism Medication

Updated: Dec 07, 2022
  • Author: William N Bennett, V, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Medication

Medication Summary

Antibiotics are useful in wound botulism, but they have no role in foodborne botulism.

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Antibiotics

Class Summary

When botulism develops following a wound infection, antibiotic therapy and meticulous debridement of the wound are essential.

Penicillin G (Pfizerpen)

Preferred drug of choice for wound botulism. Interferes with synthesis of cell wall mucopeptide during active multiplication, resulting in bactericidal activity against susceptible microorganisms.

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Antitoxins

Class Summary

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). The CDC phone number is (770) 488-7100.  Because of the risk of adverse reactions and lack of human clinical data, prophylactic antitoxin is not recommended in patients who are exposed to botulism toxin but who have no symptoms - however, it may be considered after a known high risk exposure as an extraordinary measure [9] .

Botulinum antitoxin, heptavalent (HBAT)

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.

Each 20-mL vial contains equine-derived antibody to the 7 known botulinum toxin types (A through G) with the following nominal potency values: 7500 U anti-A, 5500 U anti-B, 5000 U anti-C, 1000 U anti-D, 8500 U anti-E, 5000 U anti-F, and 1000 U anti-G.

Replaces licensed bivalent botulinum antitoxin AB (BAT-AB) and investigational monovalent botulinum antitoxin E (BAT-E). To obtain, contact CDC Emergency Operations Center; telephone: (770) 488-7100. Product to be stored in Strategic National Stockpile for emergency preparedness and responses.

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