Template:Botulism treatment

Supportive Care

• Early ventilatory support
  • Consider intubation when vital capacity <30% predicted or <12cc/kg
• Wound Managment
  • Early wound debreedment with surgical consult.
  • Also exclude Necrotizing fasciitis and coverage with same broad antibiotic coverage

Foodborne Botulism

• Equine Serum Botulism Antitoxin
  • only for patients > 1yo
• Antitoxin obtained through CDC or local Department of Health.

Infant Botulism (<1yo)

• Human-based Botulism IG 100mg/kg IV x 1 dose (BabyBIG)
  • infusion divided into 25mg/kg/hr IV x 15 min followed by 50mg/kg/hr if no allergic reactions
  • Stop infusion after total of 100mg/kg infused
• BabyBIG obtained through CDC or local Department of Health

Inhalational Botulism

• Equine Serum Botulism Antitoxin
  • only for patients > 1yo
• Antitoxin obtained through CDC or local Department of Health

Wound Botulism

• Individualize therapy with ID consultant
• Broad antibiotic coverage same as for Necrotizing fasciitis while awaiting wound cultures