With a known type of toxin (pathogen) a monovalent serum of the appropriate type is used.
Regardless of the severity of clinical symptoms, intravenous drip is administered one treatment dose of the drug, which is diluted in 200 ml of sodium chloride solution for injection 0.9%, pre-warmed before administration in warm water to a temperature of (37 ± 1) ° C. The rate of administration is 60-90 drops per minute. In exceptional cases, if drip infusion is not possible, a slow jet injection of a therapeutic dose of serum with a syringe is permitted without prior dilution.
To avoid possible allergic reactions prior to the initiation of intravenous infusion of serum, 60-90 mg of prednisolone is injected strickenly.
Serum is administered once.
For preventive purposes serum is administered to people who at the same time used the products that caused the disease with botulism. Enter half the treatment dose (half the contents of the ampoule) of the same type of serum as the type of toxin that caused the disease. If the type of toxin is not established, enter half the treatment dose of all types of monovalent sera. The drug is administered intramuscularly.
Before use, the ampoule with the drug is carefully inspected. The preparation is not suitable for use in ampoules with broken integrity, lack of marking, changing the physical properties of the preparation (discoloration, presence of non-breaking flakes), expired shelf life, improper storage.
Before the injection, the ampoule with serum is heated, keeping in water at a temperature of (37 ± 1) FROM 5 minutes.
Opening of ampoules with serum, the procedure for administering the drug and storing the opened ampoule (not more than an hour) is carried out with strict adherence to the rules of aseptic and antiseptic.
Serum administration is performed under the supervision of a physician.
Before the introduction of serum anti-botulinum to identify sensitivity to the foreign protein is mandatory intradermal with an equine serum diluted 1: 100 serum, which is complete with the drug.
Ampoules with serum of horse purified diluted 1: 100 are marked in red, and with serum anti-botulinum - in blue or black.
Serum horse purified diluted 1: 100 is administered at a dose of 0.1 ml intradermally to the flexor surface of the forearm.
The sample is considered negative if through 20 minutes swelling or redness at the injection site of less than 1 cm. The sample is considered positive if the swelling or redness reaches 1 cm or more.
For a negative intracutaneous sample, 0.1 ml of serum is injected subcutaneously anti-butulinic. If there is no response to the latter After 30 minutes, the entire prescribed dose of serum is administered intravenously or intramuscularly.
With a positive intradermal test with serum of horse purified diluted 1: 100 or in cases of allergic reactions to subcutaneous injection of undiluted serum anti-botulinum serum is administered only for medical purposes under the supervision of a physician and with special precautions: at first, after intramuscular injection of 60 mg of prednisolone and antihistamines, hypodermically serum equine diluted 1: 100 diluted, intended for intradermal test, with an interval of 20 minutes in a dose of 0.5 ml, 2.0 ml and 5.0 ml. Without reactions to these doses subcutaneously 0.1 ml of serum is injected with anti-botulinum. In the absence of reaction after 30 minutes intramuscularly administered the entire dose of serum.
In case of a positive reaction to one of the above doses, 180-240 mg of prednisolone is injected intravenously, and after 5-10 minutes, intramuscularly the entire therapeutic dose of serum.