Which action is NOT recommended in botulism management?

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The action not recommended is using antibiotics as the sole treatment. Botulism symptoms come from circulating botulinum toxin that blocks acetylcholine release at the neuromuscular junction, so removing or killing the bacteria after toxin has formed does not quickly reverse the paralysis. Antibiotics do not neutralize the toxin and cannot halt its neuroparalytic effects, and relying on them alone may delay the crucial step of toxin neutralization. The essential therapy is prompt administration of botulinum antitoxin to bind circulating toxin and prevent further progression of weakness, followed by robust supportive care. Airway management and careful respiratory monitoring are vital because respiratory muscles can be affected, and patients may need ventilation for an extended period. Recovery hinges on the regeneration of nerve terminals, which takes weeks to months, so monitoring until full recovery is important. In wound botulism, antibiotics may be used to treat the infection, but they do not replace antitoxin or supportive care for toxin-mediated disease.