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About 100 infants develop botulism in the U.S. annually. Most infants are hospitalized for 4 to 6 weeks, and many require mechanical ventilation. Investigators from California and the CDC developed and tested a human-derived botulism antitoxin in 122 infants (age range, 21 to 313 days) with laboratory-confirmed infant botulism. BIG-IV (Human Botulism Immune Globulin Intravenous) is derived from adults who were vaccinated with pentavalent botulinum toxoid.
Infants were randomized to receive BIG-IV or placebo within 3 days of hospital admission. Compared with the placebo group, infants who received BIG-IV had significantly shorter hospitalizations (mean, 5.7 vs. 2.6 weeks), and shorter duration of intensive care (5.0 vs. 1.8 weeks), mechanical…