Service pharmacie, CH de Valence, Valence, France
Botulism is a disease that must be reported to Health Authorities. These cases are serious, but exceptional in France. A botulinum antitoxin is available from the EPRUS after approval of ATU (temporary authorization for use) issued by ANSM. The administration should be earlier as possible after symptoms. Materiel and method: This work describes the management of TIAC (collective foodborne infection) by Clostridium baratii of type F botulism, identified in the stools of 3 patients having a meal in the same place in August 2015. Results: A 36 years-old patient “A”, a 49 years-old patient “B” and a 17 years-old patient “C” have abdominal pain, vomiting, difficulty swallowing and speaking, dyspnea, asthenia and xerostomia at day 1. Rapid alteration in tetraparesis and characteristic EMG allows the diagnosis of botulism and administration of antitoxin to day 5 for A and B. Patient C, diagnosed at day 11 does not allow the antitoxin administration. Amifampridine treatment is initiated for 3 patients until symptoms’ end (20-27 days of treatment). The hospital stay is 14, 26 and 37 days, and mechanical ventilation during 8, 12 and 25 days respectively for patients A, B and C. Discussion/conclusion: The administration of antitoxin in both patients (A and B) whose diagnosis was made quickly than patient C have allowed a faster recovery and retrieval ventilation, with a potential reduction in the length of the hospital stay. Results are consistent with published data on the use of botulinum antitoxin. After diagnosis, clinical and bibliographical analysis, pharmaceutical validation and rapid supplying of antitoxin by the Hospital Pharmacist are key elements in the management of this disease.