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Botulism antitoxin bivalent equine types A and B is a refined and concentrated preparation of antibody globulins obtained from horse (equine) plasma that has been immunized with botulinum toxin types A and B. The preparation consists of enzymatically digested immunoglobulins (mainly F(ab')₂ fragments), designed for passive immunization. It is indicated for the prevention and treatment of botulism caused by *Clostridium botulinum* toxin types A and B. Its mechanism is based on neutralizing circulating (unbound) botulinum neurotoxins in the bloodstream, thereby preventing their interaction with presynaptic cholinergic nerve endings and internalization into target cells. The product is administered via intravenous or intramuscular injection, with dosing depending on indication and patient characteristics. The drug is derived from equine sources, thus carries risk of hypersensitivity and serum sickness. The main developer and manufacturer was Sanofi Pasteur Limited[2].
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