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Hypersensitivity reactions associated with botulinal antitoxin

R E Black, R A Gunn

    The American Journal of Medicine
    |October 1, 1980
    PubMed
    Summary
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    Hypersensitivity reactions to equine botulinal antitoxin occurred in 9% of recipients. Using human immune globulin could significantly reduce or eliminate these risks.

    Area of Science:

    • Immunology
    • Toxicology
    • Public Health

    Background:

    • Botulinal antitoxin derived from equine sources has been used to treat botulism.
    • Hypersensitivity reactions to equine antitoxin are a known concern.

    Purpose of the Study:

    • To monitor hypersensitivity reactions to equine-derived botulinal antitoxin.
    • To assess risk factors and compare reaction rates with other equine serum products.

    Main Methods:

    • Retrospective analysis of data from 268 individuals receiving botulinal antitoxin between 1967 and 1977.
    • Monitoring of acute and delayed hypersensitivity reactions, including serum sickness.

    Main Results:

    • 9.0% of recipients experienced nonfatal hypersensitivity reactions (5.3% acute, 3.7% delayed).

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  • Serum sickness was more frequent with larger antitoxin doses (>40 ml).
  • Overall reaction rates were higher than with other equine serum products.

    • Conclusions:

    • Hypersensitivity reactions to equine botulinal antitoxin are common.
    • Alternative treatments, such as human-derived botulinal immune globulin, could mitigate these risks.