Botulism management updates

Treatment of botulism consists of antitoxin administration, hospital admission, close monitoring, respiratory support as required, and debridement plus antibiotics in the case of wound botulism. Antitoxin therapy is one of the main strategies and is available to healthcare providers in two forms: heptavalent equine serum antitoxin, indicated for patients older than 1 year, and human-derived immunoglobulin, indicated for infants under the age of 1. For wound botulism, debridement and antibiotic therapy are performed following antitoxin administration. Authors report regimens including three million units of Penicillin G intravenously (IV) every 4 hours, or metronidazole 500 mg every 8 hours for penicillin-allergic patients. Close observation by clinicians is necessary to prevent aspiration pneumonia and aggressive pulmonary toilet is recommended.