What is included in supportive care for botulism?

Updated: Feb 15, 2019
  • Author: Kirk M Chan-Tack, MD; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
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Rigorous and supportive care, including use of the following, is essential in patients with botulism:

  • Meticulous airway management - Of paramount importance, since respiratory failure is the most important threat to survival in patients with botulism

  • Cathartics and enemas - Administered to patients with bowel sounds to remove unabsorbed botulinum toxin from the intestine

  • Stress ulcer prophylaxis - A standard component of intensive care management

  • Nasogastric suction and intravenous hyperalimentation - Helpful if an ileus is present; if no ileus is present, tube feeding can be used for nutritional supplementation

  • Foley catheter - Often used to treat bladder incontinence; the catheter must be monitored conscientiously and changed regularly

  • Antibiotic therapy - Useful in wound botulism, but has no role in foodborne botulism

Magnesium salts, citrate, and sulfate should not be administered, because magnesium can potentiate the toxin-induced neuromuscular blockade.

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