Botulism Antitoxin Polyvalent A+b+e (Equine)

What it is and how it works

Purified equine immunoglobulin fragments (or immune globulin) raised against botulinum neurotoxin types A, B and E. The antibodies bind and neutralise circulating toxin before it enters nerve terminals; they cannot reverse paralysis caused by toxin already bound at the neuromuscular junction, so early administration is essential.

Indications

Treatment of suspected or confirmed foodborne, wound or other botulism caused by toxin types A, B and E, when the toxin type is unknown or before typing is available. Type E is particularly associated with fish and seafood.

Dosage and administration (summary)

Dosing is individualised according to national or manufacturer protocol, usually as an intravenous infusion given as early as possible after clinical diagnosis, without waiting for laboratory confirmation.

Contraindications

There are no absolute contraindications in life-threatening botulism; a history of hypersensitivity to equine serum requires precautions (sensitivity testing, desensitisation, premedication) rather than withholding therapy.

Warnings and precautions

Equine proteins can cause immediate hypersensitivity reactions including anaphylaxis, and delayed serum sickness 1–3 weeks after administration; administer only where resuscitation facilities are available, with adrenaline at hand. Supportive care, including mechanical ventilation, remains the mainstay of treatment. Notify public-health authorities of every suspected case.

Storage and supply

Store at 2–8 °C; do not freeze (some stockpiled products are held frozen — follow the manufacturer’s instructions).

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.