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Equine botulinum neurotoxin B immune FAB2 is a biologic antitoxin preparation composed of polyclonal antibody fragments (primarily F(ab')₂) derived from the plasma of horses immunized with botulinum toxin serotype B. It is administered intravenously for the treatment of symptomatic or suspected exposure to botulinum toxin type B in adults and pediatric patients. The mechanism of action involves high-affinity binding to circulating unbound botulinum toxin type B molecules; this prevents their attachment to ganglioside anchorage sites and membrane-bound receptors on cholinergic nerve terminals. By blocking internalization into nerve cells, it neutralizes the toxic effects before they can manifest clinically. Equine-derived antitoxins are used as emergency therapy for non-infant cases of suspected or confirmed exposure to Clostridium botulinum toxins[1][5][7].
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