Botulism is a serious neuroparalytic illness that demands prompt recognition and immediate intervention. Halting the progression of paralysis — including the risk of respiratory failure — depends on acting early with the right combination of therapies.
Management requires intensive supportive care, which may include respiratory support, alongside administration of an equine-derived botulinum antitoxin. The complete clinical pathway — including agent selection, sequencing, and monitoring criteria — is available in the full protocol.
Treatment involves supportive care, intubation and mechanical ventilation when necessary, and administration of equine-derived botulinum antitoxin.
Patients with suspected, symptomatic botulism should be treated with BAT and receive supportive care (e.g., intensive care including intubation and mechanical ventilation when necessary).
When administered early in the course of illness (within 48 hours of symptom onset and ideally within 24 hours), botulinum antitoxin can stop the progression of paralysis and prevent respiratory compromise in certain patients.
If neurologic signs progress for >1 day after administration of one vial of BAT, consider diagnoses other than botulism.
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