Pediatric Botulism Medication

Updated: Feb 28, 2019
  • Author: Muhammad Waseem, MBBS, MS, FAAP, FACEP, FAHA; Chief Editor: Russell W Steele, MD  more...
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Medication

Medication Summary

In addition to the equine-derived heptavalent botulinum antitoxin available from the CDC and FDA approved for use in non-infant botulism cases (Cangene's botulism antitoxin [BAT] heptavalent), [38] a human-derived antitoxin is currently under an Investigational New Drug (IND) treatment protocol; the treatment IND protocol is only for infant botulism and only for infants aged 1 year or younger. [39, 40] For infants who meet these criteria, the human-derived antitoxin may be obtained from the California Department of Health Services at (510) 231-7600. Information regarding treatment of older children can be obtained at http://www.bt.cdc.gov/agent/botulism.

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Antitoxins

Class Summary

These agents are used for food-borne and wound botulism. They are produced from horse serum stimulated with specific antibodies directed against C botulinum and provide passive immunity.

Botulism immune globulin, human (BabyBIG)

Solvent-detergent–treated and viral-screened immune globulin. Derived from pooled adult plasma from persons immunized with botulinum toxoid who developed high neutralizing antibody titers against botulinum neurotoxins type A and B. Indicated to treat infant botulism caused by type A or B. C botulinum.

Botulinum antitoxin, heptavalent (HBAT)

Investigational antitoxin indicated for naturally occurring non-infant 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.

Available from CDC as treatment IND protocol. 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.

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